Twelve-month complications, continuation and failure rate of CuT380A when used for immediate postpartum contraception in Tanzania: A cohort study

Abstract

Background Less than 1% of married women in Tanzania use an Intrauterine Contraceptive Device (IUD) for the purpose of contraception. An initiative by the International Federation of Gynecology and Obstetrics (FIGO) has been on since 2015 resulting in escalated method uptake in implementing hospitals. This study investigates failure rate, complications, and risk factors for one-year continuation of TCu380A IUD when used for immediate postpartum contraception under the initiative in Tanzania Methodology A prospective cohort study of women who had TCu380A insertion within 48 hours of delivery in 6 hospitals in Tanzania between 1 st December 2017 and 18 th April 2018 was conducted. Immediate, face to face post insertion interviews were made with 1114 clients and later at the beginning of 13 th month through phone calls. PPIUD continuation status, complications, duration of time they stayed with the IUD and the currently used method if PPIUD was discontinued were enquired. The outcome variable was PPIUD continuation at one year of IUD insertion. Data were analyzed using Statistical Product and Service Solutions software (SPSS) for Windows version 20 (IBM SPSS Statistics, Chicago, IL, USA). Results In total 511(45.8%)clients had consented and availed to complete the one-year follow-up. Out of these, 440 still had IUD by end of 12 months, giving a one-year continuation rate of 86.1%. Most (63%) IUD discontinuations occurred in the period between 7 th week and 6 months of insertion. One-year method expulsion rate was 2.1%. There was one reported pregnancy that gives a method failure rate of about 2 per 1000. The independent risk factors in favor of method continuation at one year were absence of medical or social problem, adolescence (16-24 years), and delivery by Cesarean section. Conclusions The continuation rate when CuT380A is used for immediate postpartum contraception is high and with low failure rate. Some medical and social factors are important for method continuation, hence the need to consider in training, counselling and advocacy.