Acceptance rate, probability of follow-up, and expulsion of postpartum intrauterine contraceptive device offered at two primary health centers, North India.

Abstract

INTRODUCTION: Acceptance rate of postpartum intrauterine contraceptive device (PPIUCD) offered through a public health approach is unknown. Our aim was to describe the acceptance rate, expulsion, and follow-up and factors associated with it when PPIUCD was offered to women delivering at two primary health centers (PHCs). METHODS: We analyzed routine health data of deliveries at two PHCs in district Faridabad, India between May and December 2014, having sociodemographic variables, obstetric history, and during the follow-up check-up at 6-weeks postpartum for in situ status of intrauterine contraceptive device, side effects, and complications. RESULTS: The overall acceptance rate among those eligible for PPIUCD was 39% (95% confidence interval [CI]: 35.1-42.9). Independent predictor of acceptance was a monthly family income of <USD75$ (odds ratio [O.R.]: 2.29, 95% CI: 1.58-3.31). The expulsion rate, and removal rate at 6 weeks postpartum was 18.0% and 13.0%, respectively. Expulsion by 6 weeks was associated with, age >25 years (O.R.: 2.21, 95% CI: 1.03-4.73), gravida ≥4 (O.R.: 4.01, 95% CI: 1.28-12.56), and a living previous-child (O.R.: 1.51, 95% CI: 1.04-2.19). CONCLUSION: Acceptance rate of PPIUCD was higher than that reported in literature. Women from lower income family, having at least one living child, and having attended antenatal care clinic were more likely to accept PPIUCD.