Acceptance Rate of Post-Partum Intra-Uterine Contraceptive Device and Factors Affecting its Uptake in a Tertiary Care Hospital in Pakistan

Objective: To determine the frequency of acceptance of Post-partum Intra-Uterine Contraceptive Device and the factors affecting its uptake in a tertiary care hospital in Karachi. Methods: This cross-sectional study was conducted in the Department of Obstetrics and Gynaecology of large public tertiary care centre in Karachi. 160 women in their immediate postpartum period were selected via consecutive non-probability sampling and counselled about the insertion of post-partum intra-uterine contraceptive device. Their willingness and the factors affecting their acceptance or refusal were documented. Women aged 20-40 years in their 36-40 weeks of gestation carrying a singleton foetus in-utero were included in the study. Past users of intrauterine devices, complicated pregnancies and emergency obstetric cases were excluded. Likewise, women carrying multiple foetuses or mal-positioned foetuses were not included. The study was carried out after due institutional approval. Results: The acceptance rate for postpartum intrauterine contraceptive devices was 23%. About 86.49% of the women acknowledged that thorough counselling made them opt for this method. Other factors that favoured its uptake were long action duration with one-time placement (70.27%), husband's approval (59.46%) and accessibility (56.76%). The majority that refused (76.9%) rejected the device due to religious beliefs (57.72%), fear of side effects (56.10%) and lack of knowledge about contraception (46.34%). Conclusion: The acceptance rate of postpartum intrauterine contraceptive devices remains low in our healthcare system. Healthcare workers and policy makers need to consider the factors responsible for its refusal for this means to be effectively utilized.