Uptake of Immediate Postpartum LARCs and Associated Factors among Mothers Who Gave Birth at Hawassa University Comprehensive Specialized Hospital, Hawassa, Ethiopia

Background Postpartum family planning is an effective strategy for reducing maternal and childhood morbidity and mortality by preventing unintended pregnancy and short interpregnancy intervals. Despite the paramount advantages of long-acting reversible contraceptives (LARC), their uptake remains low in Ethiopia. Therefore, the aim of this study was to assess the uptake of immediate postpartum LARC methods and its associated factors among women who gave birth in Hawassa University Comprehensive Specialized Hospital, Hawassa city, Southern Ethiopia. Methods An institution-based cross-sectional study was conducted among 418 eligible mothers who were in the immediate postpartum period. Data were collected using a pretested structured questionnaire before their discharge from the hospital and analyzed by using SPSS version 20. The statistical significance was declared at P value less than 0.05. Results The uptake LARCs among immediate postpartum mothers was 25.4%. The most commonly reported reasons for not using LARC were preference to start contraception after six weeks of delivery (43.3%) and the need to use other methods of contraception (26%). Having unplanned birth (AOR: 1.97; 95% CI: 1.04-3.71) and receiving family planning counselling on LARCs during the postpartum period (AOR: 21.1; 95% CI: 6.49-68.66) were factors significantly associated with immediate postpartum LARC use. Conclusion Low utilization of immediate postpartum LARC uptake was found in the current study setting. There was increased utilization of immediate postpartum LARC among mothers who received family planning counselling during the postpartum period. Therefore, strengthening family planning counselling during the immediate postpartum period is crucial to enhance postpartum LARC use.

[1]  M. Birara,et al.  Factors affecting long-term and permanent contraceptive uptake among immediate post-partum mothers at Saint Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia: a cross-sectional study , 2018 .

[2]  A. Medhanyie,et al.  Postnatal care utilization among urban women in northern Ethiopia: cross-sectional survey , 2018, BMC Women's Health.

[3]  Habtamu Jarso,et al.  Prevalence, and Pattern of LARC Use in Immediate Postpartum Period at Jimma University Medical Center, Ethiopia [18F] , 2018 .

[4]  A. Gelagay,et al.  Family planning use and its associated factors among women in the extended postpartum period in Addis Ababa, Ethiopia , 2018, Contraception and Reproductive Medicine.

[5]  Jennifer A. Unger,et al.  Uptake and correlates of contraception among postpartum women in Kenya: results from a national cross-sectional survey. , 2017, Contraception.

[6]  David A. Klein,et al.  Postpartum contraception: initiation and effectiveness in a large universal healthcare system , 2017, American journal of obstetrics and gynecology.

[7]  D. Tesfaye,et al.  Utilization of Immediate Post-Partum Intra Uterine Contraceptive Device andAssociated Factors: A Facility based Cross Sectional Study among MothersDelivered at Public Health Facilities of Sidama Zone, South Ethiopia , 2017 .

[8]  M. Tafa,et al.  Prevalence and Determinant Factors of Long Acting Contraceptive Utilization among Married Women of Reproductive Age in Adaba Town, West Arsi Zone, Oromia, Ethiopia , 2017 .

[9]  Committee Opinion No. 670: Immediate Postpartum Long-Acting Reversible Contraception , 2016, Obstetrics and gynecology.

[10]  Melissa F Peskin,et al.  Choice of Postpartum Contraception: Factors Predisposing Pregnant Adolescents to Choose Less Effective Methods Over Long-Acting Reversible Contraception. , 2016, The Journal of adolescent health : official publication of the Society for Adolescent Medicine.

[11]  A. Barros,et al.  Patterns and trends of postpartum family planning in Ethiopia, Malawi, and Nigeria: evidence of missed opportunities for integration , 2015, Global health action.

[12]  S. Agha,et al.  The Role of Quality Health Services and Discussion about Birth Spacing in Postpartum Contraceptive Use in Sindh, Pakistan: A Multilevel Analysis , 2015, PloS one.

[13]  M. D. Argaw,et al.  Determinants of Long Acting Reversible Contraception Method use among mothers in Extended Postpartum Period, Durame Town, Southern Ethiopia: a cross sectional community based survey. , 2015 .

[14]  J. Kinuthia,et al.  Factors influencing uptake of contraceptive implants in the immediate postpartum period among HIV infected and uninfected women at two Kenyan District Hospitals , 2015, BMC Women's Health.

[15]  Senafikish Amsalu Feleke,et al.  Contraceptive adoption in the extended postpartum period is low in Northwest Ethiopia , 2015, BMC Pregnancy and Childbirth.

[16]  T. Croft,et al.  Missed opportunities for family planning: an analysis of pregnancy risk and contraceptive method use among postpartum women in 21 low- and middle-income countries. , 2015, Contraception.

[17]  C. Orach,et al.  The effect of prenatal counselling on postpartum family planning use among early postpartum women in Masindi and Kiryandongo districts, Uganda , 2015, The Pan African medical journal.

[18]  Allen Kabagenyi,et al.  Predictors of modern contraceptive use during the postpartum period among women in Uganda: a population-based cross sectional study , 2015, BMC Public Health.

[19]  Denise V. D’Angelo,et al.  Contraceptive counseling and postpartum contraceptive use. , 2015, American journal of obstetrics and gynecology.

[20]  A. Chimwaza,et al.  Utilization of Postpartum Family Planning Services between Six and Twelve Months of Delivery at Ntchisi District Hospital, Malawi , 2014 .

[21]  C. Izugbara,et al.  Unintended pregnancy and subsequent use of modern contraceptive among slum and non-slum women in Nairobi, Kenya , 2014, BMC Pregnancy and Childbirth.

[22]  P. Darney,et al.  Interpregnancy intervals: impact of postpartum contraceptive effectiveness and coverage. , 2014, American journal of obstetrics and gynecology.

[23]  R. Ali Acceptability and safety of postpartum intrauterine contraceptive device among parturients at Muhimbili national hospital, Tanzania. , 2012 .

[24]  J. Trussell Medical eligibility criteria for contraceptive use , 2011 .

[25]  A. Glasier,et al.  Pregnancy during breastfeeding in rural Egypt. , 2008, Contraception.

[26]  S. Barber Family planning advice and postpartum contraceptive use among low-income women in Mexico. , 2007, International family planning perspectives.

[27]  A. Conde-Agudelo,et al.  Birth spacing and risk of adverse perinatal outcomes: a meta-analysis. , 2006, JAMA.

[28]  A. Conde-Agudelo,et al.  Maternal morbidity and mortality associated with interpregnancy interval: cross sectional study , 2000, BMJ : British Medical Journal.

[29]  J. Darroch,et al.  Adding it up: The costs and benefits of investing in sexual and reproductive health 2014. , 2014 .