A select issue in the postpartum period: contraception

Cowman, Whitney; Hardy-Fairbanks, Abbey J; Endres, Jill; Stockdale, Colleen K.

doi:10.17077/2154-4751.1198

Cited by 3 publications

(1 citation statement)

References 41 publications

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“…A variety of literature showed that factors like maternal age [ 15 , 16 ], employment status [ 17 ], religion or culture [ 4 , 18 – 21 ], lack of awareness of family planning methods [ 14 , 20 , 22 ], male involvement [ 4 , 18 , 21 ], extended family [ 18 , 23 ], death of child [ 17 ], antenatal care follow up [ 24 ], inaccessibility of family planning methods [ 18 , 20 ], and fear of side effects [ 18 ] were some of the factors affecting PPFP use among women in the postpartum period [ 4 ].…”

Section: Introductionmentioning

confidence: 99%

Family planning use and its associated factors among women in the extended postpartum period in Addis Ababa, Ethiopia

Gebremedhin

Kebede

Gelagay

et al. 2018

Contracept Reprod Med

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BackgroundPostpartum period is an important entry point for family planning service provision; however, women in Ethiopia are usually uncertain about the use of family planning methods during this period. Limited studies have been conducted to assess postpartum family planning use in Addis Ababa, in particular and in the country in general. So, this study was conducted to assess postpartum family planning use and its associated factors among women in extended postpartum period in Kolfe Keranyo sub city of Addis Ababa.Materials and methodsA community-based cross sectional study was conducted from May to June 2015 on 803 women who have had live births during the year (2014) preceding the data collection in the sub city. The multi-stage cluster sampling technique was used to select study participants. Data were collected by interviewer administered structured questionnaire, entered into EPI INFO version 7 and analyzed by SPSS Version 20. Bivariable and Multivariable logistic regression models were employed to see the presence and strength of the association between the dependent and independent variables by computing the odds ratios with a 95% confidence intervals and p-values.ResultsThe prevalence of postpartum family planning use was 80.3% (95% CI: 74.5, 83.1). Marriage, (AOR 0.09, 95% CI: 0.03, 0.22), menses resumption after birth, (AOR 2.12, 95% CI: 1.37, 3.41), length of time after delivery, (AOR 2.37, 95% CI: 1.18, 4.75), and history of contraceptive use before last pregnancy, (AOR 0.12, 95% CI: 0.07, 0.18) were the factors associated with postpartum family planning use.ConclusionThe prevalence of postpartum family planning use was high and the main factors associated with it were marriage, menses resumption, length of time after delivery, and history of previous contraceptive use. Therefore women should get appropriate information about the possibility of exposure to pregnancy prior to menses resumption by giving special emphasis to those who had no previous history of contraceptive use and exposure to the other identified factors.

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Section: Introductionmentioning

confidence: 99%

Family planning use and its associated factors among women in the extended postpartum period in Addis Ababa, Ethiopia

Gebremedhin

Kebede

Gelagay

et al. 2018

Contracept Reprod Med

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Postpartum Tubal Sterilization: Making the Case for Urgency

Richardson

Hall

Zuckerwise

2018

Anesthesia &Amp; Analgesia

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The parturient who requests postpartum sterilization has given consideration to and has made decisions regarding this aspect of her medical care long before her delivery. She arrives at parturition expecting the postpartum procedure to be performed as intended. The American Congress of Obstetricians and Gynecologists has reaffirmed its opinion that postpartum sterilization is an urgent procedure, owing to the safety and superior effectiveness of tubal sterilization via minilaparotomy in the immediate postpartum period, and the adverse consequences for mothers, babies, and society when the procedure is not actualized as desired and intended. In contrast, recent practice guidelines for obstetric anesthesia address anesthetic procedural aspects and short-term safety but overlook the long-term complications and considerations associated with failure to perform postpartum sterilization as planned. In practice, procedure completion rates are strikingly low, reportedly ranging from 31% to 52%. Reasons for failure to complete abound and include inadequate resources or inavailability of necessary personnel; obstetrician reluctance due to concerns for patient regret in younger women or medical comorbidities; barriers related to provision of obstetric care in a religiously affiliated hospital, or incomplete, improperly completed, or unavailable original federal consent forms among Medicaid-insured women. The federal requirement to wait 30 days after signing informed consent, and to retain the original signed document to be physically verified at time of the procedure, serves as a significant source of health care disparity for Medicaid-dependent mothers. This article reviews these larger issues of maternal health and comprehensive maternal care to broaden the anesthesiologist's appreciation of major benefits and potential risks of postpartum sterilization, including long-term effects, to promote an evidence-based, informed, and proactive role in delivering equitable, safe, and optimal care for these patients.

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