Introduction: Improving postpartum contraceptive use is an important programmatic strategy to improve the health and well-being of women, newborns and children in a country. The aim of this study was to assess the knowledge, attitudes and practices regarding postpartum contraception among postnatal mothers. Methods: A cross sectional study on 300 postnatal mothers was carried at Teaching Hospital Mahamodara (THM) Galle. Multiparous mothers were recruited using convenient sampling method. Data collection was done using a validated, self-administered structured questionnaire after obtaining informed consent. Questionnaire was designed to assess on knowledge, attitudes and practices of postpartum contraception. Results: Level of knowledge regarding postpartum contraception was above average in 15.8% of mothers and below average in 46.6% of them. The majority of them were aware regarding Combined Oral Contraceptives Pills (COCP). Almost 60% of women of Islamic and Hindu religions believed that contraception is not accepted by their religion. Among postnatal mothers, 70.2% had previous practices of postpartum contraception and the commonest method used was COCP. Approximately 76% of mothers gained information regarding postpartum family planning from Public Health Midwives (PHM). Conclusions: Knowledge on post-partum contraception in general was inadequate. The attitudes and practices on postpartum contraception were influenced by their religion. Short acting contraceptives were popular method of contraception among postnatal mothers. The major information provider was PHM.
Background: Birth preparedness (BP) and complication readiness (CR) is a concept introduced by World Health Organization (WHO) for reduction of maternal and neonatal mortality rate of a country. This study was aimed to evaluate the level of knowledge and practices on BP and CR and associated factors among antenatal mothers attending antenatal clinic (ANC) of Teaching Hospital Mahamodara (THM). Methods: A descriptive cross sectional study was conducted in THM,Galle, from 200 third trimester antenatal mothers who attended to ANC using pretested selfadministered questionnaire from July 2016. It consisted with close ended questions in three sections; basic socio-demographic data, 47 facts about awareness of BP and CR and evaluation of practices of BP and CR based on WHO criteria. Data were analyzed using t-test, Chi-square test and logistic regression. Results: Mean age of the study participants was 29 (+/-5.34). BP and CR were known concepts by 88.5% (95% CI: 84.08% to 92.92%) participants. Knowledge on BP and CR were reported as above average in 92.5% (95% CI: 88.85 to 96.15%) and 78.0% (95% CI: 72.26% to 83.74%) mothers respectively. Mothers who practiced BP and CR were 83.5% (95% CI: 78.36% to 88.64%). Young mothers have better knowledge on BP than older mothers (OR = 3.77; 95% CI: 1.16 to 12.24). Older mothers had statistically significant better knowledge on CR (OR = 0.73; 95% CI 0.66 to 0.93). There were statistically significant positive association of knowledge on CR with ethnicity (p = 0.03), family income (p = 0.04) and parity (p = 0.03). There was statistically significant positive association with better educational level (OR=0.31, 95% CI=0.11 to 0.91) and planned pregnancy (OR=0.26, 95% CI=0.10 to 0.70) with level of practice on BP and CR. Conclusion: BP and CR were well-known concept among third trimester mothers. Level of knowledge and practices on BP and CR were satisfactory among the study sample. Women with higher maternal age had poor knowledge on BP. Women with better educational level and planned pregnancy had satisfactory practices on BP and CR.
Objectives: To evaluate rectal diclofenac sodium in the relief of perineal pain after trauma during childbirth.Design: A randomized , double blind trial. Setting:The obstetric department (ward 21) , Professorial Unit, Colombo South Teaching Hospital, Kalubowila.Population: Women with an episiotomy or any degree of perineal tears including vestibular tears, which required suturing.Method: Women were randomly allocated to either diclofenac sodium or placebo suppositories (Anusol) , using a random -number table. Treatment packs contained two, diclofenac sodium 100 mg and diclofenac sodium 50 mg suppositories or two placebo suppositories, The first (diclofenac sodium100mg or placebo) was inserted when suturing was completed , and the second (50 mg diclofenac sodium or placebo) 12 hours after birth. Women were asked to indicate their degree of perineal pain at 24 hours after birth, using 10 cm visual analogue scale. Main outcome measure: Pain score at 24 hours after birth.Results: A total of 169 women were recruited, with 84 randomized to diclofenac sodium suppositories and 85 to placebo. Women in the diclofenac sodium group were significantly less likely to experience pain within 24 hours of delivery (percentage of mean pain score reduction , 45% , P < .001 ) compared with those who received placebo. Conclusions:The use of rectal diclofenac sodium is a simple and effective method of reducing the pain experienced by women following perineal trauma within the first 24 hours after childbirth.
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