Antenatal Counselling: Does it Boost the Uptake of Post Placental Intrauterine Contraceptive Device?

Abstract

Objective: To evaluate antenatal counselling increases the uptake of post-placental intrauterine contraceptive devices in women delivering at a tertiary level obstetric unit.

Methodology: A quasi-experimental study was conducted in the Department of Obstetrics & Gynaecology, Maternal and Child Health Center (MCHC), Pakistan Institute of Medical Sciences (PIMS), Islamabad from Nov 2016 to Oct 2017. The intervention group (A) included 125 women fulfilling the inclusion criteria. They were given repeated sessions of structured antenatal counselling regarding uptake of post-placental intrauterine contraceptive device (PPIUCD). These were women of 18-40 years of age, with at least one alive child, a structurally normal, singleton fetus, with no history of preterm labour, pelvic infections or menstrual irregularity. Also, women who sustained miscarriage, PROM>18 hours. Pregnancy termination or stillbirth were to be subsequently excluded from the study.  The comparative group (B) were 125 consenting women who fulfilled the inclusion criterion but were offered routine counselling in early labour and immediate post-placental period. After delivery (caesarean section or vaginal delivery), women opting for PPIUCD were fitted with copper IUCD in both groups. A Chi-square test was applied to compare both groups. P value of <0.05 was taken as significant.

Results: Out of the 125 women enrolled in-group A, 02 were excluded due to PPROM. The number of women who had PPIUCD inserted in group A was 66/123 (53.6%) while that in group B was 46/125(36.8%).  The result was significantly significant p<0.03.

Conclusion: Repeated antenatal counselling results  in significantly higher uptake of post placental IUCD.