scholarly journals Determinants of Method Switching among Social Franchise Clients Who Discontinued the Use of Intrauterine Contraceptive Device

2015 ◽  
Vol 2015 ◽  
pp. 1-8 ◽  
Author(s):  
Waqas Hameed ◽  
Syed Khurram Azmat ◽  
Moazzam Ali ◽  
Wajahat Hussain ◽  
Ghulam Mustafa ◽  
...  

Introduction. Women who do not switch to alternate methods after contraceptive discontinuation, for reasons other than the desire to get pregnant or not needing it, are at obvious risk for unplanned pregnancies or unwanted births. This paper examines the factors that influence women to switch from Intrauterine Contraceptive Device (IUCD) to other methods instead of terminating contraceptive usage altogether.Methods. The data used for this study comes from a larger cross-sectional survey conducted in nine (9) randomly selected districts of Sindh and Punjab provinces of Pakistan, during January 2011. Using Stata 11.2, we analyzed data on 333 women, who reported the removal of IUCDs due to reasons other than the desire to get pregnant.Results. We found that 39.9% of the women do not switch to another method of contraception within one month after IUCD discontinuation. Use of contraception before IUCD insertion increases the odds for method switching by 2.26 times after removal. Similarly, postremoval follow-up by community health worker doubles (OR = 2.0) the chances of method switching. Compared with women who received free IUCD service (via voucher scheme), the method switching is 2.01 times higher among women who had paid for IUCD insertion.Conclusion. To increase the likelihood of method switching among IUCD discontinuers this study emphasizes the need for postremoval client counseling, follow-up by healthcare provider, improved choices to a wider range of contraceptives for poor clients, and user satisfaction.

2019 ◽  
Vol 12 (9) ◽  
pp. e231410
Author(s):  
Mahdi Abdulrasoul Al Sahaf ◽  
Bahaa Farouk Bseiso ◽  
Sami Abdulmohsin Al-Momen ◽  
Abdul-Wahed Nasir Meshikhes

Intrauterine contraceptive device (IUCD) is a common birth control method. It is safe but can be associated with serious complications including migration into the peritoneal cavity and penetration into other intra-abdominal and pelvic viscera; most commonly the rectosigmoid colon. Different retrieval methods including endoscopy, laparoscopy or open abdominal surgery have been described. We report the case of 38-year-old woman who became pregnant shortly after insertion of the IUCD 6 years prior to presentation. She delivered vaginally and ‘expulsion’ of the device was assumed. Some 4 years later, she had another IUCD inserted and remained asymptomatic till she recently presented with iron-deficiency anaemia. As part of the investigation, diagnostic colonoscopy was performed. Surprisingly, the old IUCD was found penetrating into the midrectum. Uneventful endoscopic removal was performed and she remained well at 3-month follow-up. Migrating IUCD remains asymptomatic and may be discovered accidentally during routine investigation for some other symptoms.


2021 ◽  
Vol 15 (9) ◽  
pp. 2785-2788
Author(s):  
Saba Abbas ◽  
Sadia Anwar ◽  
Kalsoom Essa Bhattani ◽  
Zubaida Khanum Wazir ◽  
Rubina Babar

Background and Aim: Postpartum intrauterine device (PPIUD) is a reversible, long-term and effective technique of contraception. The intrauterine device (IUD) is inserted within 48 hours of delivery. The immediate insertion of an intrauterine device causes certain complications. The present study aimed to assess the prevalence of complications after Interval Postpartum Intrauterine Device Insertion. Materials and Methods: This cross-sectional study was carried out on 147 women who underwent postpartum IUD (PPIUD) insertions during from January 2021 to June 2021 at Gynecology department, Mufti Mehmood Memorial Teaching Hospital (MMMTH), Dera Ismail Khan and Muhammad Teaching Hospital Peshawar. All the women who delivered and showed willingness for PPIUCD insertion were enrolled and continuously follow-up for 4 to 6 weeks after delivery. Demographic, obstetric, and clinical parameters were recorded on pre-designed medical proforma. PPIUCD insertion after 6 weeks of delivery were followed-up for the evaluation of complications. Uterine infection, medical removal of IUD, IUD expulsion, perforation, and method discontinuation were the outcome variables. SPSS version 20 was used for data analysis. Results: Of the total deliveries, 147 women inserted the postpartum intrauterine contraceptive device (PPIUCD). Of the total, about 122 (83%) women returned for follow-up after 6 weeks. All the women underwent transvaginal insertion of intrauterine contraceptive devices. The PPIUCD insertion related complications with prevalence were uterine infection 26 (21.3%), overall method suspension 17 (13.9%), perforation 20 (16.4%), interceptive uterine device expulsions 25 (20.5%), and intrauterine device removal 32 (26.2%). The severe uterine infection was in 2 (1.7%) cases who were hospitalized. Conclusion: The postpartum intrauterine device cumulative expulsion rate was higher among women compared to the expulsion rate of insertions. The longer duration of bloody lochia flow and delivery intrauterine device insertions were the key risk factors for expulsion of PPIUCD. Women can safely utilize intrauterine contraceptive devices with low complications beyond four week. Keywords: Postpartum intrauterine device; Complications; Intrauterine device expulsion


Author(s):  
Sravani Mukka ◽  
Madhavi Y.

Background: In India almost 65% of the women have an unmet need for family planning in the first postpartum year. Increasing rates of institutional deliveries creates an opportunity for providing quality post-partum family planning services. Post-partum Intrauterine contraceptive device (PPIUCD), a form of long acting reversible contraception (LARC) is one of the most affective and safest method available. The present study aims at evaluating the safety, efficacy, rate of acceptance and rate of discontinuation of Intra caesarean inserted contraceptive device Copper T-380A.Methods: This was a prospective study conducted at ESIC Medical College, Sanathnagar in women delivered by caesarean section during the period between March 2018 to February 2019. Recruitment was done based on the WHO medical eligibility criteria (MEC) for PPIUCD and also their willingness to participate in the study. Follow-up visits were scheduled at 6 weeks, 3 months and 6 months.Results: Of the 265 women fulfilling the WHO MEC, 180 (67.92%) were willing to participate in the study. Total acceptance rate was 67.7%. Majority of them belonged to the age group 21-30 years (80%) and para 2 (53.88). 93.3% of the women were literates. 12 (6.66%) cases lost to follow up and the complications were studied in the rest 168 women. During follow up -38.69% had missing strings, 12.5% menstrual disturbances, 4.76% abdominal pain and spontaneous expulsion in 4.1%. No cases of perforation and pregnancy were reported. Total continuation rate was 84%.Conclusions: PPIUCD is a safe and convenient option of contraception with low expulsion rates and high continuation rates.


Author(s):  
Nidhi Gupta ◽  
Renuka Sinha ◽  
Abha Mangal

Background: The objectives of the study were to assess knowledge, attitude and practice in post-partum intrauterine contraceptive device method of family planning and to know about willingness for post-partum intrauterine contraceptive device (PPIUCD) when knowledge is provided for the same.Methods: This is a cross sectional observational study including 1200 patients of immediate post-partum period (<48 hrs of delivery), delivered at Safdarjung hospital. Women were evaluated with the help of a pre-designed and pre-tested questionnaire.Results: Out of 1200 women 864 (72%) were aware of some family planning method but only 672 (56%) had used some family planning method in the past. 108 (9%) women had knowledge regarding Post-partum intrauterine contraceptive device (PPIUCD). Among these, 72 (6%) women opted for PPIUCD. After knowledge regarding PPIUCD had been given, 80 more women adopted this as a method of contraception. So total 152 (12.67%) opted PPIUCD.Conclusions: This study highlights that awareness and knowledge does not always lead to use of contraceptives. A lot of educational and motivational activities are needed.


2014 ◽  
Vol 8 (2) ◽  
pp. 16-20 ◽  
Author(s):  
R Joshi ◽  
S Bhattarai ◽  
K Simkhada ◽  
S Thapa

Aims: This study aimed to identify the determinants of Intrauterine Contraceptive Device (IUCD) use among the married women of reproductive age group living in urban areas of Nepal. Methods: This study was an analytical cross-sectional study which aimed to compare different factors between 110 IUCD users and 110 non-users. Both groups were selected randomlyand interviewed by using semi-structured questionnaire. Chi-square test was used to detect the difference between two groups and corresponding odds ratios with 95% confidence intervals were also computed. Results: When the IUCD users were compared to non-users, religion, occupational status of women, occupational status of the husbands, total number of children, sources of information about IUCD, having wrong beliefs about IUCD, availability of IUCD services, reproductive intention and spousal communication were significantly associated with the use of IUCD.The main reason for using IUCD was due to the effectiveness for longer duration and for not using IUCD was due to the feeling of no need. Conclusions: Wrong beliefs about the device discouraged women from using IUCD, hence, awareness programs are strongly recommended.Nepal Journal of Obstetrics and Gynaecology / Vol 8 / No. 2 / Issue 16 / July-Dec, 2013 / 16-20 DOI: http://dx.doi.org/10.3126/njog.v8i2.9760


2020 ◽  
Vol 28 (4) ◽  
pp. 367-371
Author(s):  
Qudsia Qazi ◽  
Nazia Liaqat ◽  
Shehzadi Saima Hussain ◽  
Saima Khattak

BACKGROUND: Family planning helps couples to attain their desired number of children and proper timings of their births (1). It is best achieved with different contraceptive methods. Immediate postpartum intrauterine contraceptive device (IPPIUCD) is an excellent contraception providing safe, effective and long term reversible contraception in women after both normal delivery and c/section(2). It reduces postpartum undesired pregnancies and thus induced abortions (3). It is coitus independent, easy to insert and does not affect breastfeeding. Both care provider and client are available in the same setting, securing time and cost of interval IUD insertion.  PPIUCD is associated with primary complications like pregnancy and secondary ones as irregular vaginal bleeding, abdominal pain, infection, expulsion and uterine perforation. PPIUCD counselling services regarding its common side effects and complications are important. There is minimal research comparing follow up outcomes between vaginal and caesarean insertions. The objective of study is to compare outcomes of IPPIUCD as a factor of route of insertion. METHODS: In this prospective comparative study 200 patients in whom postpartum IUCD was inserted within 10 minutes of delivery of placenta after normal vaginal delivery or c/section were included. About first 100 cases of vaginal and first 100 cases of intra-cesarean PPIUCD insertions formed study groups. Record of clients was maintained and analysis at 6 weeks to 12 weeks post insertion follow up visit was done at gynae and obstetric unit of Lady Reading Hospital Peshawar. RESULTS: Of total 1005 IPPIUCD inserted during the study period, about 156( 15.5%) were inserted intra-cesarean and 849 (84.4%) after vaginal delivery. Follow up of 200 (19.9%) clients i.e. about 100 intra-cesarean and 100 vaginal insertions was recorded. Complications rate was low. No life threatening complication such as perforation was recorded. Most common complications observed between vaginal vs intra-cesarean insertions were irregular vaginal bleeding in (11% vs 5%), abdominal pain(6% vs 9%), vaginal discharge(8% vs 5%),spontaneous expulsions  (8% vs 2%) and lost strings (14% vs 1%). Statistically significant difference was found between two groups with respect to lost strings (P=0.0006). CONCLUSION: IPPIUCD is an acceptable, safe (in terms of complications) and effective contraceptive option after both vaginal and intra-cesarean insertions. Early follow up examinations are helpful in identifying spontaneous expulsions and dealing common problem.


Author(s):  
T. K. Shaanthy Gunasingh ◽  
T. S. Meena ◽  
R. Mothilal

Background: Postpartum intrauterine contraceptive device is a postpartum family planning method which provides spacing to the next pregnancy and also it helps to avoid unwanted / unintended pregnancy during postpartum period. Our aim was to study the willingness and acceptability of Postpartum intrauterine contraceptive device among primi paraous women and compare them as a factor of route of insertion (vaginal versus caesarean).Methods: A cross sectional analytical study was done in a tertiary care teaching institution to know the willingness and acceptance among primi paraous delivery (either vaginal and caesarean deliveries) for the period of three months using the hospital records that a total number of 587 primi paraous deliveries and among them 433 mothers had Postpartum intrauterine contraceptive device over the three months period, were taken as a secondary data and studied for their willingness and acceptance for Postpartum intrauterine contraceptive device.Results: 82.8 % of primi paraous women were showing willingness for Postpartum intrauterine contraceptive device and 73.8 % of them had Postpartum intrauterine contraceptive device insertion. Postpartum intrauterine contraceptive device insertions were more in caesarean deliveries than in vaginal deliveries of mothers with one child.Conclusions: Postpartum intrauterine contraceptive device is a strong weapon in the family planning and should be encouraged in both vaginal and caesarean deliveries. The acceptability of Postpartum intrauterine contraceptive device in women with one child was effective and statistically significant at p value is < 0.05.


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