Postpartum contraception utilization and its impact on inter pregnancy interval among mothers accessing maternity services in the public sector hospital of Hyderabad Sindh: Postpartum contraceptive utilization and its impact on inter-pregnancy interval

Objective: To find out the particulars regarding contraceptive practices in the postpartum period and to see its impact on prolonging interpregnancy interval (IPI).

Methods: A cross sectional observational study was conducted in the Department of Obstetrics & Gynecology Unit 3, Liaquat University Hospital Hyderabad from 1st July to 31st December 2018. Out of 2100 total deliveries, 398 postpartum women with second or higher order births were included. Pregnant women, primiparas and those who were not willing to participate were excluded. They were interviewed face to face by principal investigator and her team members and required information was collected on predesigned Performa. Outcome variable was interpregnancy interval in months. Chi-square test was used to see association

Results: Postpartum contraception utilization (PPC) was 24.6%(n=398). Most of the women choose condoms as contraceptive method (n=41, 10.3%) followed by oral contraceptive pills (n=18, 4.5%) and intra uterine contraceptive device (n=16,4%). Method related issues were the chief reasons for discontinuation while desire to have another child soon and spouse/family disapproval were among the reasons mentioned largely by non-utilizers of modern methods of family planning. The average interpregnancy interval was 16.4±1.45. Significant association was observed between interpregnancy interval and postpartum contraception use, particularly in the users of long acting reversible contraceptive methods (P-Value 0.0001).

Conclusion: Uptake and continuation of modern methods of contraception was low after last birth culminating in short interpregnancy interval. Optimal IPI was observed in those utilizing modern methods of family planning, with marked effect in users of long acting reversible contraceptive methods.