Factors affecting acceptance of immediate postpartum contraception at a tertiary hospital in northern Nigeria

Abstract

Background: Postpartum contraception is a simple measure that can potentially impact positively on quality of life of mothers and their families, and reduce overall maternal mortality and morbidity, especially in low resource settings.

Aims: To determine factors affecting acceptance of contraception in the immediate post-partum period.

Methodology: This was a cross sectional study carried out between January 2019 to December 2021. A convenient sample of women in the immediate postpartum period had exit interviews, using a semi-structured interviewer administered questionnaire and information was obtained on sociodemographic and reproductive characteristics, pregnancy and delivery history, and reasons for accepting or refusing contraception. Data analysis was done using simple descriptive and inferential statistics. A p-value of < 0.05 was considered statistically significant.

Results: A total of 455 women participated in the study. The mean age of respondents was 29.32 ± 6.31 years, and most women were parous with 1-4 children (313,68.8%). Only 199 women (43.7%) accepted immediate postpartum contraception, mostly implants (166 women) and intra-uterine devices (18 women). Reasons for accepting contraception was to rest, heal and regain strength while reasons for refusing were husband – related factors and the perception that it was too early to initiate contraception. Several factors were significantly associated with uptake of contraception (P- value < 0.05) including age, ethnicity, duration of marriage, parity, number and sex of children alive, desire for more children, previous unplanned pregnancy, accoucheur, time and mode of delivery, outcome of index pregnancy, previous use of contraception and timing of contraceptive counselling.

Conclusion: Acceptance of immediate postpartum can be increased by educating women about their need and safety, greater male involvement and creating opportunities for multiple counselling sessions antenatally.