ACCEPTANCE OF POSTPARTUM CONTRACEPTION AND IMPACT OF FAMILY PLANNING COUNCELLING IN POSTPARTUM PERIOD

Abstract

Background: Family planning counseling plays a crucial role in informed contraceptive decision-making in the postnatal period. However, the effectiveness of these interventions in influencing contraceptive uptake remains underexplored. Aim of present study was to assess the impact of structured family planning counseling on the acceptance of contraceptive methods among postnatal women.

Methods: This prospective study included 250 antenatal and postnatal women who received standardized family planning counseling from a tertiary care center. Contraceptive acceptance was measured at postpartum. Data on demographic variables, counseling content, and subsequent contraceptive choices were collected and analyzed.

Results: In our study, family planning counseling demonstrated a significant impact on the acceptance of contraceptive methods among postnatal women. Out of the 250 participants counseled, 85% (n=213) opted for some form of contraception at the six-week follow-up. The contraceptive preferences varied, with long-acting reversible contraceptives (LARCs) being the most preferred choice by 45% of the women (n=113), followed by oral contraceptive pills at 22% (n=55), condoms at 11% (n=28), and injectable contraceptives at 8% (n=20).

Women with a college degree or higher showed a higher uptake rate (95%, 114 out of 120) compared to those with high school education or less (75%, 98 out of 130). Age also influenced decisions; younger mothers aged 18-25 were more inclined towards LARCs (52%, 59 out of 113) compared to their older counterparts aged 26-35 (38%, 43 out of 113). Further analysis revealed that women’s understanding of the contraceptive options, gauged through a questionnaire assessing their knowledge at the follow-up, correlated with higher uptake rates. Those scoring above 80% on knowledge questions accepted contraception at a rate of 90% (95 out of 106), versus a 70% acceptance rate among those with lower scores (79 out of 113).

Multivariate logistic regression identified several predictors of contraceptive acceptance: higher education (Odds Ratio = 2.1, 95% Confidence Interval: 1.2 – 3.5), prior knowledge of contraception (Odds Ratio = 1.8, 95% Confidence Interval: 1.1 – 2.9), and receipt of follow-up counseling (Odds Ratio = 3.4, 95% Confidence Interval: 1.5 – 7.6) were all significant.

Conclusion: Effective family planning counseling significantly influences contraceptive acceptance among postnatal women. Enhanced counseling, along with follow-up, can lead to higher uptake of contraceptive methods particularly LARCs, continuous antenatal and postnatal contraception councelling is very effective tool to accept postpartum contraception and acceptance may vary  from antenatal councelling choice.