PMID- 37456407
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20230718
IS  - 2168-8184 (Print)
IS  - 2168-8184 (Electronic)
IS  - 2168-8184 (Linking)
VI  - 15
IP  - 6
DP  - 2023 Jun
TI  - The Acceptance of Postpartum Intrauterine Contraceptive Devices Among Women Who 
      Receive Focused Family Planning Counseling in the Antenatal Period Compared to 
      Those Who Receive Routine Counseling: A Randomized Controlled Trial.
PG  - e40344
LID - 10.7759/cureus.40344 [doi]
LID - e40344
AB  - Background and objective Unplanned pregnancies are very common in the postpartum 
      period, and they often lead to negative outcomes such as abortion, 
      low-birth-weight neonates, early delivery, postpartum bleeding, and fetal 
      mortality. In the first 12 months after delivery, closely spaced and 
      unintentional pregnancies can be prevented with postpartum contraception. The 
      postpartum intrauterine contraceptive device (PPIUCD) is a method of family 
      planning that may be used during the first few weeks after giving birth, and it 
      is highly successful, reliable, affordable, non-hormonal, immediately reversible, 
      long-acting, and does not interfere with lactation. Urban and educated women are 
      largely aware of IUCD and its benefits, but the proportion of these women who use 
      them is still small. In light of this, this study aimed to assess if providing 
      focused antenatal counseling led to a greater postpartum IUCD acceptance 
      rate when compared to routine counseling. Method We conducted a randomized 
      controlled trial in the Department of Obstetrics and Gynaecology of a tertiary 
      care center from January 2021 to December 2022. Based on the inclusion and 
      exclusion criteria, 220 women were enrolled and were classified into two groups. 
      Group A comprised 110 women (the focused counseling group) who received focused 
      postpartum family planning (PPFP) counseling, and Group B consisted of the 
      control group involving 110 women who received routine counseling. Results In 
      both groups, the women who inserted IUCD were mostly gravida 2. Additionally, 
      willingness to use IUCD was shown by 68% of women in the focused counseling group 
      and 58% of women in the routine counseling group, and PPIUCD was accepted by 22% 
      of women in the focused counseling group and 9% of women in the routine 
      counseling group. Post-placental insertion was carried out in 18 (75%) cases in 
      the focused counseling group and seven (70%) cases in the routine counseling 
      group. Extended postpartum insertion (insertion within one year of delivery) was 
      carried out in six (25%) cases in the focused counseling group and three (30%) 
      cases in the routine counseling group. The most common reasons for the refusal 
      were a preference for tubal ligation (TL) and a fear of side effects. When the 
      patients were enquired about their contraceptive use over the past year on 
      telephone conversations after one year of delivery, it was observed that 21.81% 
      inserted PPIUCD, 30% used injectable depot-medroxyprogesterone acetate (DMPA), 
      13.63% had undergone TL, 11.81% used barrier contraception, while 22.72% did not 
      use any contraception in the focussed counseling group. In the routine counseling 
      group, 16.36% of women inserted PPIUCD, 20% used injectable DMPA, 12.72% 
      underwent TL, 18.18% used barrier contraception, and 32.72% did not use any 
      contraception. Conclusion Although PPIUCD is a long-acting reversible 
      contraceptive that is safe and reliable, only a few women choose it as a method 
      of birth control. This may be due to ignorance, misconceptions, and worries/fears 
      about potential difficulties/adverse effects associated with IUCD insertion. The 
      IUCD stigma mostly results from misconceptions about the fear of complications. 
      Hence, we recommend that proper IUCD counseling be provided during antenatal care 
      visits to dispel misunderstandings and concerns regarding potential complications 
      associated with PPIUCD insertion.
CI  - Copyright (c) 2023, Najan et al.
FAU - Najan, Ashwini
AU  - Najan A
AD  - Department of Obstetrics and Gynaecology, NKP Salve Institute of Medical Sciences 
      and Research Centre, Nagpur, IND.
FAU - Dixit, Prachi
AU  - Dixit P
AD  - Department of Obstetrics and Gynaecology, NKP Salve Institute of Medical Sciences 
      and Research Centre, Nagpur, IND.
FAU - Bhalerao, Anuja
AU  - Bhalerao A
AD  - Department of Obstetrics and Gynaecology, NKP Salve Institute of Medical Sciences 
      and Research Centre, Nagpur, IND.
LA  - eng
PT  - Journal Article
DEP - 20230612
PL  - United States
TA  - Cureus
JT  - Cureus
JID - 101596737
PMC - PMC10338990
OTO - NOTNLM
OT  - antenatal women
OT  - family planning
OT  - post-partum intrauterine contraceptive device
OT  - routine antenatal counseling
OT  - tubal ligation
COIS- The authors have declared that no competing interests exist.
EDAT- 2023/07/17 06:42
MHDA- 2023/07/17 06:43
PMCR- 2023/06/12
CRDT- 2023/07/17 04:23
PHST- 2023/06/12 00:00 [accepted]
PHST- 2023/07/17 06:43 [medline]
PHST- 2023/07/17 06:42 [pubmed]
PHST- 2023/07/17 04:23 [entrez]
PHST- 2023/06/12 00:00 [pmc-release]
AID - 10.7759/cureus.40344 [doi]
PST - epublish
SO  - Cureus. 2023 Jun 12;15(6):e40344. doi: 10.7759/cureus.40344. eCollection 2023 
      Jun.