Evaluating postpartum intrauterine contraceptive device insertions in a tertiary care setting

Abstract

Background: Postpartum family planning is critical for reducing unintended pregnancies and improving maternal and neonatal outcomes. The postpartum intrauterine contraceptive device (PPIUCD) is a long-acting, reversible, and safe method, but acceptance and continuation vary widely due to sociocultural and clinical factors.Aim: To assess the factors associated with acceptance, safety, and reasons for non-acceptance of PPIUCD, and to determine the factors influencing discontinuation along with adverse event rates.Materials and Methods: A prospective observational study was conducted among 250 postpartum women in a tertiary care hospital. Counselling was provided antenatally and postpartum. Women who accepted PPIUCD underwent post-placental or intra-caesarean insertion. Follow-up was conducted at six weeks and six months to document continuation, complications, removals, and expulsions. Data were analysed using descriptive and inferential statistics, with p<0.05 considered significant.Results: The acceptance rate was 62%, significantly influenced by awareness and counselling. Reversibility, perceived safety, and family approval were major factors promoting acceptance, while fear of complications and partner refusal were primary reasons for non-acceptance. Follow-up revealed low rates of expulsion, infection, and removal, confirming good safety and acceptability.Conclusion: PPIUCD is a safe, acceptable, and effective postpartum contraceptive option. Strengthened counselling, partner involvement, and structured follow-up can enhance acceptance and continuation.