Abstract:

Postpartum contraception is the use of modern methods of contraception as soon as possible after childbirth and the continued practice of this or an alternative method for at least twenty-four months to optimize the timing and spacing of pregnancies. This study aimed to assess postpartum contraception among women attending the Tamale Teaching Hospital (TTH) in Ghana. A cross-sectional survey was conducted among postpartum women attending TTH from November 1^st to 30^th, 2021. A simple random sampling method was used to select 422. Data was collected using structured questionnaires. Out of 400 respondents, 135 (33.5%) were currently using a contraceptive, the majority of whom (57, 44.9%) preferred the injectable. There was an association between contraceptive use and respondents' education level, marital status, occupation, and partner’s educational level (p = 0.001, 0.005, 0.001, and 0.000, respectively). There was an association between contraceptive use and the age of the last child of respondents, respondents desiring to have another child and a positive history of contraceptive use (p= 0.015,0.003 and 0.000, respectively). 113 (28.2%) did not use contraceptives because they were afraid of becoming infertile. Postpartum contraceptive use is low among women in Tamale. The most preferred method of contraception is the injectable. The utilization of contraceptives among respondents is affected by socio-demographic characteristics as well as reproductive characteristics. The primary reason for the non-use of contraceptives was fear of infertility. More education on contraceptive use and its benefits should be intensified among women to improve its prevalence.

References:

[1].      World Health Organization, Geneva, Switzerland.

[2].      World Health Organization, 2013. Programming strategies for postpartum family planning.

[3].      Cleland, J., Conde-Agudelo, A., Peterson, H., Ross, J., & Tsui, A., 2012, Contraception and health. The Lancet, 380(9837), 149–156. https://doi.org/10.1016/S0140-6736(12)60609-6

[4].      World Health Organization, 2005, Report of a WHO technical consultation on birth spacing. Report of a WHO Technical Consultation on Birth Spacing, 13(6), 1–44. http://www.who.int/maternal_child_adolescent/documents/birth_spacing.pdf

[5].      Cleland, J., Bernstein, S., Ezeh, A., Faundes, A., Glasier, A., & Innis, J. (2006). Family planning: The unfinished agenda. Lancet (London, England), 368(9549), 1810–1827. https://doi.org/10.1016/S0140-6736(06)69480-4

[6].      Yeakey, M. P., Muntifering, C. J., Ramachandran, D. V., Myint, Y. M., Creanga, A. A., & Tsui, A. O., 2009, How contraceptive use affects birth intervals: Results of a literature review. Studies in Family Planning, 40(3), 205–214. https://doi.org/10.1111/J.1728-4465.2009.00203.X/ABSTRACT

[7].      Ghana Statistical Service, 2016, Health of Women and Children in Ghana.

[8].      Jackson, E., & Glasier, A., 2011, Return of ovulation and menses in postpartum nonlactating women: A systematic review. Obstetrics and Gynecology, 117(3), 657–662. https://doi.org/10.1097/AOG.0b013e31820ce18c

[9].      Aviisah, P. A., Dery, S., Atsu, B. K., Yawson, A., Alotaibi, R. M., Rezk, H. R., & Guure, C., 2018, Modern contraceptive use among women of reproductive age in Ghana : analysis of the 2003 – 2014 Ghana Demographic and Health Surveys. 1–10.

[10].  Wassihun, B., Wosen, K., Getie, A., Belay, K., Tesfaye, R., Tadesse, T., Alemayehu, Y., Yihune, M., Aklilu, A., Gebayehu, K., & Zeleke, S., 2021, Prevalence of postpartum family planning utilization and associated factors among postpartum mothers in Arba Minch town, South Ethiopia. Contracept Reprod Med 6, 6, https://doi.org/10.1186/s40834-021-00150-z

[11].  Houston, S., Barros, A. J. D., Amouzou, A., Shiferaw, S., Maïga, A., Akinyemi, A., Koroma, D., 2015, Patterns and trends of contraceptive use among sexually active adolescents in Burkina Faso, Ethiopia, and Nigeria: evidence from cross-sectional studies. Global Health Action, 8(1). https://doi.org/10.3402/gha.v8.29737

[12].  Tran, N. T., Yameogo, W. M. E., Langwana, F., & et al., 2018, Participatory action research to identify a package of interventions to promote postpartum family planning in Burkina Faso and the Democratic Republic of Congo. BMC Women's Health, 18, 122.

[13].  Cleland, J., Shah, I. H., & Daniele, M., 2015. Interventions to Improve Postpartum Family Planning in Low- and Middle-Income Countries: Program Implications and Research Priorities. Studies in Family Planning, 46(4), 423–441. https://doi.org/10.1111/j.1728-4465.2015.00041.x

[14].  Coomson, J. I., Manu, A., 2019, Determinants of modern contraceptive use among postpartum women in two health facilities in urban Ghana: a cross-sectional study. Contracept Reprod Med 4, 17. https://doi.org/10.1186/s40834-019-0098-9

[15].  Bahk, J., Yun, S., Kim, Y., & Khang, Y., 2015, Impact of unintended pregnancy on maternal mental health : a causal analysis using follow-up data of the Panel Study on Korean Children (PSKC). 1–12. https://doi.org/10.1186/s12884-015-0505-4

[16].  Moore, Z., Pfitzer, A., Gubin, R., Charurat, E., Elliott, L., & Croft, T., 2015, Missed opportunities for family planning: An analysis of pregnancy risk and contraceptive method use among postpartum women in 21 low- and middle-income countries. Contraception, 92(1), 31-39. https://doi.org/10.1016/j.contraception.2015.03.007

[17].  Abera, Y., Mengesha, Z. B., & Tessema, G. A., 2015, Postpartum contraceptive use in Gondar town, Northwest Ethiopia: A community-based cross-sectional study. BMC Women's Health, 15(19). https://doi.org/10.1186/s12905-015-0178-1

[18].  Jalang’o, R., Thuita, F., Barasa, S. O., & et al., 2017, Determinants of contraceptive use among postpartum women in a county hospital in rural Kenya. BMC Public Health, 17, 604. https://doi.org/10.1186/s12889-017-4510-6

[19].  Blumenthal P. D., Voedisch A., Gemzell-Danielsson K., 2011, Strategies to prevent unintended pregnancy: increasing use of long-acting reversible contraception. Hum Reprod Update. 2011;17:121–37. Doi: 10.1093/humupd/dmq026.

[20].  Achyut, P., Mishra, A., Montana, L., & et al., 2016, Integration of family planning with maternal health services: An opportunity to increase postpartum modern contraceptive use in urban Uttar Pradesh, India. Journal of Family Planning and Reproductive Health Care, 42, 107-115.

[21].  Gebremedhin, A. Y., Kebede, Y., Gelagay, A. A., & et al., 2018, Family planning use and its associated factors among women in the extended postpartum period in Addis Ababa, Ethiopia. Contraception and Reproductive Medicine, 3, 1. https://doi.org/10.1186/s40834-017-0054-5

[22].  Dombola, G. M., Manda, W. C., & Chipeta, E., 2021, Factors influencing contraceptive decision making and use among young adolescents in urban Lilongwe, Malawi: A qualitative study. Reproductive Health, 18, 209. https://doi.org/10.1186/s12978-021-01259-9

[23].  Burdette, A. M., Haynes, S. H., Hill, T. D., & Bartkowski, J. P., 2014, Religious variations in perceived infertility and inconsistent contraceptive use among unmarried young adults in the United States. Journal of Adolescent Health, 54(6), 704-709. https://doi.org/10.1016/j.jadohealth.2013.11.002

[24].  Apanga, P. A., & Adam, M. A., 2015. Factors Influencing the Uptake of Family Planning Services in the Talensi District, Ghana. Pan African Medical Journal, 20, 10. https://doi.org/10.11604/pamj.2015.20.10.5301