Acceptance, safety and efficacy of Postpartum intrauterine contraceptive device (PPIUCD) insertion at tertiary health care centre.

Abstract

Background: The unmet need for contraception in the postpartum period is a major challenge in our country. According to survey done by USAID/ ACCESS, 65% of women in first year postpartum have an Unmet need for family planning in India. Pregnancy before 24 Months of previous birth increase maternal and perinatal morbidity and mortality.  Unintended pregnancies are highest in the first year after birth, and postpartum IUCD insertion is an effective and reversible way to counter this problem. This study was planned to study acceptability, safety, efficacy and complication of PPIUCD. Methods: This retrospective study was conducted at Smt. Kashibai Navale medical college, from   January 2019 to December 2021. Patients were followed up at 6 weeks and 6 months period after insertion of PPIUCD for its acceptance and complaints. Results: Total 450 patients were inserted PPIUCD during study period. Overall acceptance rate was 85.4%. Most common cause for removal of PPIUCD was family pressure (36.4%) followed by pain in lower abdomen (34.8%). Acceptance rate was higher between 25 to 30 years of age (44.79 %). On follow up after 6 months of insertion 82.97 % women had no any complaint. Most common complaints were lower abdominal pain (10.22%), missing thread (6.57%) and vaginal discharge (5.11%). Only 17 (3.7%) women complained about expulsion of IUCD. There was no any case of perforation or failure reported. Conclusions: Present study shows that PPIUCD is a safe, highly effective, low-cost and long-acting method of contraception. It is beneficial for Indian women where unmet need is high for contraception during postpartum period.

Keywords: Post partum, acceptance, Intra caesarean, Post placental, PPIUCD