Awareness and Uptake of Immediate Postpartum Long-Acting Reversible Contraception Among Women in Northern Nigeria

Abstract

Background

The postpartum period is a vulnerable period for women for unintended pregnancies and also an ideal time to start highly effective contraception in order to prevent unintended pregnancy and achieve appropriate childbirth spacing.

Aim and Objectives

To determine the awareness, level of uptake of IPP LARC and factors affecting the uptake of IPP LARC in Ahmadu Bello University Teaching Hospital (ABUTH), Shika, Zaria, Northwest Nigeria.

Method

A cross sectional study conducted within three months on 123 women, recruited from the reproductive health, antenatal and postnatal clinics of the hospital. The data was collected using a semi-structured interviewer administered questionnaire and analysed using the statistical package for social sciences (SPSS version 25.0), Chi-square test was used to test for significant association between variables, with the level of significance set at P < 0.05 and the results were presented using tables and charts.

Results

All the women were aware of contraception however only 32.5% had heard of any form of immediate postpartum contraception and only 20.3% had heard of IPP LARC. Implants were the commonly known IPP LARC (17.9%) and only 4.1% knew IPP IUCD. Only 6.5% had used contraception within 6 weeks postpartum and only 1.6% had used IPP LARC despite 21.1% having resumed menses within 6 weeks. There was an association between awareness and uptake of IPP LARC (P = 0.005). The intended acceptability rate for IPP LARC in women that had never used was 62% and the common reasons for non-utilization were lack of awareness (56.9%), fear of side effects (26%), ignorance about availability of the service in the hospital (24.4%) and husbands’ disapproval (11.4%).

Conclusion

Awareness and uptake of IPP LARC was low despite the good awareness and uptake of contraception in general. Reasons for the poor uptake include lack of awareness, ignorance about the availability of the service in the facility, fear of side effects and husbands’ disapproval. This makes it pertinent that couple targeted postpartum contraception counselling be included in routine contraception counselling.

Keywords: Immediate postpartum contraception, Long acting reversible contraception, Implant, intrauterine contraceptive device