Assessment of the Contraceptive Needs and Practice of Women in the Extended Postpartum Period in Bahir Dar, Ethiopia

Mulu, Shegaw (2007) Assessment of the Contraceptive Needs and Practice of Women in the Extended Postpartum Period in Bahir Dar, Ethiopia. Masters thesis, Addis Ababa University.

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Abstract

Background: The extended postpartum period is the time which is usually given less emphasis regarding family planning by policy makers, service providers and users. However, it is a time with a rising risk of unwanted conception and an often-frustrated desire for contraceptive protection. The contraceptive behavior of women in the extended postpartum period is usually different from other times in a woman’s life cycle due to breast feeding, postpartum amenorrhea, postpartum sexual abstinence or concerns of women on the effect of contraceptives on breast milk. Understanding the contraceptive behaviors, needs and preferences of women in this period is important to design an effective family planning program in the postpartum period. Objective: the objective of this study is to examine the contraceptive needs and practices of women during the extended postpartum period. Methods: A community based cross sectional study was conducted in Bahir Dar town. All the Kebeles of the town were included in the study, each Kebele contributing sample proportional to its size. A total of 387 women who were in the first year after delivery were interviewed by trained data collectors using a structured and pre tested questionnaire. Data were entered, cleaned and analyzed using SPSS version 13. First, Crude odds ratios were calculated using logistic regression for which 95% confidence interval was determined. Then, adjusted odds ratio was done for variables that have significant association during the crude analysis to control for potential confounders. Result: The prevalence of modern contraceptive use was found to be 48.8% among women in the extended postpartum period. The majority of current contraceptive users were using injectables 129(68.3%) followed by pills 48(25.4%). Non breast feeding women were more likely to practice contraceptives than currently breast feeding women (AOR=8.689, 95%CI=2.226-13.925). Women who had ANC and postpartum visit to health institutions were more likely to use contraceptives (AOR=3.689, 95% CI=1.517-8.971 and AOR=2.803, 95% CI=1.277-6.149 respectively). The major reason for not using contraceptives was feeling of insusceptibility to pregnancy due to amenorrhea after delivery (34%). Short term hormonal contraceptives (pills and injectables) were started very early during exclusive breast feeding and long before resumption of menses (83.1% of the total contraceptive users start contraceptives in the first 12 weeks after birth). Of the total women exposed to the risk ofpregnancy, 156(78.8%) were using modern contraceptives and 42(21.2%) were not using any FP method. Only 109(28.2%) of the study subjects have heard about LAM. Nobody correctly knows the criteria for LAM to be effective. Conclusion: Resumption of menses, breast feeding status, marital status, ANC, postpartum visit to health professionals were found to be associated with use of family planning methods in the extended postpartum period. The majority of the need for FP during the EPPP was met by LAM and postpartum sexual abstinence. Knowledge and practice of LAM and long term family planning methods was very low. The contraceptive method mix during the extended post partum period should be revised by family planning program managers and providers. LAM can be considered as an effective and feasible FP method choice in the study area provided that family planning providers educate and counsel women about LAM during the prenatal and post natal periods. Counseling of women about LAM and long term FP methods is recommended.

Item Type: Thesis (Masters)
Uncontrolled Keywords: LAM, extended postpartum period, exclusive breast feeding, lactational amenorrhea.
Subjects: R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine
Divisions: Africana
Depositing User: Emmanuel Ndorimana
Date Deposited: 19 Nov 2018 10:47
Last Modified: 19 Nov 2018 10:47
URI: http://thesisbank.jhia.ac.ke/id/eprint/7486

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