Intra Uterine Contraceptive Device: Socio-Demographic Characteristics of Acceptors Acceptability and Effectiveness in a Tertiary Institution.Mymensingh Med J 2018; 27(3):527-535MM
To assess the acceptability and efficacy immediate Postpartum Intrauterine Contraceptive Device (PPIUCD) among parturient at Bangabandhu Sheikh Mujib Medical University (BSMMU), Bangladesh; this prospective interventional analytical study was conducted from January 2013 to June 2013. Contraceptive counseling was given to 370 eligible parturient after delivery during their postpartum hospitalization. A pre-tested structured data collection sheet was administered to all participants. Women who accepted the PPIUCD during their postpartum care were inserted with the device before discharge (within 48 hours). These women were followed up at 6 weeks for complications. The acceptance rate of PPIUCD and the percentage of actual insertions were recorded. The reasons for both acceptances and decline were also recorded. Of the 370 women counseled, a total of 132(35.67%) were inserted with PPIUCD. Parturient who had a short duration from their last child birth (2-3) were significantly associated with greater acceptance of the PPIUCD. Preference of other methods of contraception mainly short acting methods and the need to discuss with their partners were the most common reasons for declining use of PPIUCD. More than half (51.51%) of the women whom PPIUCD was inserted did so due to its long term effect. Immediate PPIUCD was demonstrably safe due to its low rates of complications. The common complications at six weeks interval were expulsion (5.8%) and lost strings (2.5%) and pelvic infection (1.66%). Acceptance of PPIUCD was relatively high probably because of its 'newness' in the community. For these women, the best opportunity to receive information about contraception is during child birth when they are in contact with healthcare providers. It is also important to emphasize and educate women on long term methods of contraception as majority of the women preferred short term methods despite their future pregnancy desires of more than three years. Couple counseling should also be promoted. The government needs to develop strategies to increase public awareness of the PPIUCD through different media sources.