The unmet need for contraception among Nigerian women in the first year post-partum

Adeyemi, Adebanjo Babalola; Ijadunola, Kayode T.; Orji, Ernest O.; Kuti, Oluwafemi; Alabi, Marie M.

doi:10.1080/13625180500279763

Cited by 38 publications

(46 citation statements)

References 11 publications

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“…Regardless of menstrual status, women 0-5 months postpartum who are exclusively breastfeeding are unlikely to have ovulatory cycles; for these women, ovulation returns later in the first year or once other foods are introduced [16]. Research has shown that postpartum women misunderstand the return to fecundity [18,[26][27][28]. This is true even among self-reported LAM users: a recent analysis of DHS data showed that many did not adhere to all three criteria for LAM effectiveness at the time of the survey [29].…”

Section: Discussionmentioning

confidence: 99%

Missed opportunities for family planning: an analysis of pregnancy risk and contraceptive method use among postpartum women in 21 low- and middle-income countries

et al. 2015

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Objectives: To analyze data from recent Demographic and Health Surveys (DHS) conducted in 21 low-and middle-income countries (LMICs) to examine patterns of interpregnancy intervals, unmet need, pregnancy risk and family planning method use and method mix among women 0-23 months postpartum. Study design: Secondary analysis of postpartum women aged 15-49 years in 22 DHS surveys from 21 LMICs conducted between 2005 and 2012. We applied an adapted unmet need definition for postpartum women to look at prospective fertility preferences. We also constructed a new composite pregnancy risk indicator for postpartum women who have been sexually active since their last birth. Results: In 9 of 22 surveys, 50% or more of nonfirst births occur at interpregnancy intervals that are too short. Overall prospective unmet need for family planning by postpartum women has not changed demonstrably since a 2001 analysis and is universally high: 61% of all postpartum women across the 21 countries have an unmet need for family planning. In 10 of 22 surveys, pregnancy risk rises steadily throughout the 2 years after birth. In the remaining 12 surveys, the risk of pregnancy peaks at 6-11 months after birth. Even when postpartum women are using family planning, they rely overwhelmingly on short-acting methods (51-96% in 21 of 22 surveys). Conclusion: Our approach of estimating pregnancy risk by postpartum timing confirms a high probability for pregnancies to be less than optimally spaced within 2 years of a prior birth and suggests that special consideration is needed to effectively reach this population with the right messages and services. Implications: Using recent, multicountry data for women within 2 years postpartum in LMICs, this paper updates existing estimates of high prospective unmet need for family planning and presents a new composite pregnancy risk analysis based on postpartum women's actual practices to demonstrate the magnitude of missed opportunities for programmatic intervention for the postpartum population.

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Section: Discussionmentioning

confidence: 99%

Missed opportunities for family planning: an analysis of pregnancy risk and contraceptive method use among postpartum women in 21 low- and middle-income countries

et al. 2015

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“…It promotes the health of mothers and children by lengthening pregnancy interval and helps to avoid financial, psychological, and health costs due to unintended pregnancies. However, following childbirth many families overlook contraception due to a poor perception of pregnancy risks, difficulty in accessing services, and sociocultural issues [5, 6]. Many factors such as geographical and financial access, provider bias, poor method choice, lower status of women, medicolegal restrictions, and fear of side effects act as a barrier to family planning use [7].…”

Section: Introductionmentioning

confidence: 99%

Unmet Need for Family Planning in Nepal during the First Two Years Postpartum

Mehata

Paudel²,

Mehta

et al. 2014

BioMed Research International

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Contraceptive use during the postpartum period is critical for maternal and child health. However, little is known about the use of family planning and the determinants in Nepal during this period. This study explored pregnancy spacing, unmet need, family planning use, and fertility behaviour among postpartum women in Nepal using child level data from the Nepal Demographic and Health Surveys 2011. More than one-quarter of women who gave birth in the last five years became pregnant within 24 months of giving birth and 52% had an unmet need for family planning within 24 months postpartum. Significantly higher rates of unmet need were found among rural and hill residents, the poorest quintile, and Muslims. Despite wanting to space or limit pregnancies, nonuse of modern family planning methods by women and returned fertility increased the risk of unintended pregnancy. High unmet need for family planning in Nepal, especially in high risk groups, indicates the need for more equitable and higher quality postpartum family planning services, including availability of range of methods and counselling which will help to further reduce maternal, perinatal, and neonatal morbidity and mortality in Nepal.

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“…Although the majority of postpartum women indicate a desire to delay a next birth, FP methods are often not offered to, or taken up by, women after delivery or in the first year postpartum [3,5-7]. Based on the Health Belief Model, which has been widely used in the study of contraceptive use, perceived threat (perceived susceptibility and perceived severity), perceived benefits, cues to action, and self-efficacy are known to influence contraceptive behaviors [8-10].…”

Section: Introductionmentioning

confidence: 99%

Influence of integrated services on postpartum family planning use: a cross-sectional survey from urban Senegal

et al. 2013

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BackgroundAlthough the majority of postpartum women indicate a desire to delay a next birth, family planning (FP) methods are often not offered to, or taken up by, women in the first year postpartum. This study uses data from urban Senegal to examine exposure to FP information and services at the time of delivery and at child immunization appointments and to determine if these points of integration are associated with greater use of postpartum FP.MethodsA representative, household sample of women, ages 15–49, was surveyed from six cities in Senegal in 2011. This study focuses on women who were within two years postpartum (n = 1879). We also include women who were surveyed through exit interviews after a visit to a high volume health facility in the same six cities; clients included were visiting the health facility for delivery, post-abortion care, postnatal care, and child immunization services (n = 794). Descriptive analyses are presented to examine exposure to FP services among postpartum women and women visiting the health facility. Logistic regression models are used to estimate the effect of integrated services on postpartum FP use in the household sample of women. Analyses were conducted using Stata version 12.ResultsAmong exit interview clients, knowledge of integrated services is high but only a few reported receiving FP services. A majority of the women who did not receive FP services indicated an interest in receiving such information and services.Among the household sample of women up to two-years postpartum, those who received FP information at the time of delivery are more likely to be using modern FP postpartum than their counterparts who also delivered in a facility but did not receive such information. Exposure to FP services at an immunization visit was not significantly related to postpartum FP use. Another key finding is that women with greater self-efficacy are more likely to use a modern FP method.ConclusionThis study’s findings lend strong support for the need to improve integration of FP services into maternal, newborn, and child health services with the goal of increasing postpartum women’s use of FP methods in urban Senegal.

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The unmet need for contraception among Nigerian women in the first year post-partum

Cited by 38 publications

References 11 publications

Missed opportunities for family planning: an analysis of pregnancy risk and contraceptive method use among postpartum women in 21 low- and middle-income countries

Missed opportunities for family planning: an analysis of pregnancy risk and contraceptive method use among postpartum women in 21 low- and middle-income countries

Unmet Need for Family Planning in Nepal during the First Two Years Postpartum

Influence of integrated services on postpartum family planning use: a cross-sectional survey from urban Senegal

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