FACTORS ASSOCIATED WITH ACCEPTANCE AND REFUSAL FOR PPIUCD AT TERTIARY CARE TEACHING HOSPITAL IN MAHARASHTRA

Background: Postpartum Intrauterine Contraceptives (PPIUCDs) offer a highly effective, reliable, cost effective,non hormonal, immediately reversible, long active contraception which can be used immediately after birth and has no negative effects on breast feeding. Despite these benefits, the acceptance and utilization of immediate PPIUCD were very low and the reasons for rejecting immediate PPIUCD usage have not been characterized in Maharashtra. This study aims to determine the level of acceptability and factors associated with rejection of immediate PPIUCD use among women who gave birth at Pravara Institute of Medical Sciences, Loni, Maharashtra.

Methods: This was a cross-sectional study, conducted from August to September 2023 at Pravara Institute of Medical Sciences, Loni, Maharashtra. Three hundred fifty-one women were randomly selected and were interviewed using structured and pre-tested questionnaire. Statistical analysis was done using SPSS version 21, and results were found to be statistically significant (p-value <0.05).

Results: The acceptance of immediate PPIUCD usage was found to be 22.5%. The reasons for rejection of PPIUCD use were husband refusal (35.9%), religious beliefs (33.7%), and concern and fears of complications (30.4%). Women who had completed secondary education were more likely to accept PPIUCD usage than those who had no formal education. There was a higher inclination of PPIUCD use in women who had attended 3 antenatal care visits than those who did not attend the antenatal care visits for current pregnancy.

Conclusions: Currently the acceptance rate for PPIUCD is low. This is mostly attributed to low education of the couple, male partners refusal and religious beliefs, and perceived fear and concerns regarding complications associated with the insertion of PPIUCD. Higher inclination for PPIUCD insertion among counselled women during Antenatal Care visits indicates the importance of patients and partners counselling regarding benefits of PPIUCDs, correction of fear and concerns regarding the procedure and the need for proper family planning.