One-year continuation of postpartum intrauterine contraceptive device: findings from a retrospective cohort study in India.
Contraception
; 99(4): 212-216, 2019 04.
Article
em En
| MEDLINE
| ID: mdl-30576637
ABSTRACT
OBJECTIVE:
To evaluate outcomes of a national postpartum (within 48â¯h of delivery) copper intrauterine device placement (PPCuIUD) program in six "high-focus states" with high unmet family planning need in India. STUDYDESIGN:
We identified high-volume district hospitals that provided PPCuIUD in six (Bihar, Jharkhand, Uttar Pradesh, Uttarakhand, Madhya Pradesh and Chhattisgarh) Indian states (two per state). Each selected hospital maintained a list of PPCuIUD acceptors with contact phone numbers. We randomly selected 100 women at each site for inclusion in a telephone survey of IUD outcomes at 1 year. Questions regarded IUD expulsion, discontinuation because of symptoms (e.g., pain, bleeding, discharge), discontinuation for other reasons and use of alternative contraception if discontinuation reported.RESULTS:
We could contact 844 of the 1200 randomly selected women, of whom 673 (79.7%) had postplacental insertion (within 10â¯min of delivery), while 171 (20.3%) had an early postpartum insertion (between 10â¯min to 48â¯h after delivery). Of those contacted, 530 women (62.8%) reported continuing with the method beyond 1 year, 63 (7.5%) reported having an expulsion, 163 (19.3%) reported having removals for associated side effects (bleeding, pain and discharge), and 88 (10.4%) reported having removals for other reasons. After removal or expulsion, almost half of the women (46.5%) did not switch to any other modern contraceptive method.CONCLUSION:
PPCuIUD continuation rate at 1â¯year was 62.8%. Most removals within 1 year were due to associated side effects. Almost half of the women discontinuing PPCuIUD did not switch to an alternative modern contraceptive method. IMPLICATIONS The 1-year continuation rate of PPCuIUD achieved through a large-scale national program in India is satisfactory. The program though needs to address the low uptake of other modern contraceptive methods after discontinuation.Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Dispositivos Intrauterinos de Cobre
Tipo de estudo:
Diagnostic_studies
/
Etiology_studies
/
Observational_studies
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Prognostic_studies
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Risk_factors_studies
Limite:
Adult
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Female
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Humans
País como assunto:
Asia
Idioma:
En
Ano de publicação:
2019
Tipo de documento:
Article