Acceptability for the use of postpartum intrauterine contraceptive devices: Assiut experience.

Department of Obstetrics and Gynecology, Faculty of Medicine, Assiut University, Assiut, Egypt.
Medical Principles and Practice (Impact Factor: 0.96). 01/2003; 12(3):170-5. DOI: 10.1159/000070754
Source: PubMed

ABSTRACT To evaluate the acceptance of postpartum intrauterine contraceptive devices (PPIUCD) among the inhabitants of Assiut governorate, Egypt and to study the factors that influence this acceptance.
Contraceptive counseling was given to 3,541 clients: 1,880 and 1,661 during the antenatal visits and postpartum hospitalization, respectively. Acceptors during antenatal counseling were to receive IUCDs via postplacental insertion in the case of vaginal delivery or transcesarean insertion in case of abdominal delivery. The clients who refused PPIUCD and chose interval IUCD insertion were referred to the Family Planning Clinic after the end of puerperium. Among postpartum counselees, PPIUCD acceptors received predischarge insertion within 48 h of delivery and the interval IUCD were referred to have IUCD inserted after the end of puerperium. The acceptance rate of both PPIUCD and interval IUCD and the percentage of actual insertions were recorded. The causes of both acceptance and refusal were also recorded.
Of the 3,541 clients, 1,024 (28.9%) accepted the use of IUCD after delivery. Acceptance was approximately the same during antenal and postpartum counseling: 26.4 and 31.8%, respectively. Verbal acceptance was higher among women with formal education than among illiterate women. Planning another pregnancy in the near future, preference for another contraceptive method, namely lactational infertility, and complications from previous use of IUCD were the most common reasons for refusing the use of IUCD. Of the 1,024 verbal acceptors, only 243 (23.7%) had the actual insertion of IUCD.
Both the acceptance and actual insertion of IUCD were low probably because the use of IUCD is a new concept in the community. For these women, the only opportunity to receive information about contraceptives is during childbirth when they are in contact with medical personnel. Hence, it is suggested that family planning should be integrated with maternal and child-care services in order to effectively promote the use of contraceptive devices in these women who otherwise would not seek the use of such a device.

  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Existing questionnaires to assess barriers against consultation for urinary incontinence (UI) are not appropriate for use in the Middle East culture. The aim of this study was to explore barriers against seeking help for UI and introducing a questionnaire that assess these barriers among those women. This is important before proceeding to any educational programs or having interval clinical audits to help incontinent women. 1- Screening for UI. Women - aged 20 years and older, attending the outpatient Urology and Gynaecology clinics were invited to participate and interviewed by a research nurse. The UDI-6 was administered to assess the presence and type of UI. Women with UI as their chief complaint were excluded. 2- Interviewing study subjects for possible barriers. Subjects who had UI - as determined by the UDI-6-were first asked an open question "what prevented you from seeking medical consultation for urine leakage?"." They were then asked the proposed questions to assess possible barriers. We developed a preliminary questionnaire based on a review of reasons for not seeking incontinence care from the literature and the response of UI sufferers to the open question in this study. The questionnaire was modified many times to reach this final form. 3- Pilot Study to assess characteristics of the questionnaire. Validity and reliability of the final version of the questionnaire were assessed in a small pilot study including 36 women who completed questionnaire at initial visit and again after 2 weeks. Of the 1231 subjects who agreed to participate in the study, 348 reported having UI. About 80% of incontinent women have never sought medical advice. Factors significantly associated with seeking help were husband encouragement, prayer affection and having severe UI. Common barriers were embarrassment and assuming UI as a normal part of aging. A pilot study included 36 women to assess the psychometric properties of the questionnaire after modifying it. The number of missing or not interpretable responses per item ranged from 2.2% to 8.7%. Internal consistency of the items was good. The test-retest reliability of individual items of the questionnaire was variable, with weighted kappa statistics ranging from 0.32 to 0.94 (median, 0.76, p 0.000). Preliminary data on our proposed questionnaire show that it is an easy to administer, stable and suits the Middle Eastern culture.
    BMC Women s Health 01/2010; 10:3. · 1.51 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: To explore the degree of knowledge, perception, and practice of emergency contraception (EC) within marital relations in Egypt. The present study was a pilot cross-sectional survey. Eligible participants were randomly selected from 4 governorates in Upper Egypt. A questionnaire was designed by the investigators and administered to an unselected sample of healthcare providers and potential users of EC. The questionnaire collected information in 4 domains: demographics; knowledge about EC; attitudes toward EC; and practice of EC in Egypt. In total, 240 healthcare providers and 60 potential users of EC completed the questionnaire. Approximately 85% of healthcare providers and 30% of potential users had heard about EC. A similar proportion of study participants said that EC methods are needed. Only 32.7% of healthcare providers and very few potential users had actually used EC. There is a need for EC in Egypt. However, a big gap in knowledge leads to nonuse or incorrect use of EC and negative attitude toward it. If health service planners and policy makers could fill this gap, a considerable decline in the prevalence of unwanted pregnancy may be achieved by using EC.
    International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics 03/2011; 112(3):195-9. · 1.41 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Background: Long acting reversible contraceptives are family planning methods that prevent unwanted pregnancy for at least three years and when removed return of fertility is prompt. It includes the intrauterine device and contraceptive implants. Despite the effectiveness and reversibility of fertility, the acceptance and utilization of long acting reversible contraceptive were very low in many developing countries including Ethiopia. Even though the optimal use of long-acting reversible contraception is a good strategy for reducing unintended pregnancy, acceptability to long acting reversible contraceptive is fundamental to effective and continuous use. Objective: This study was aimed to assess the acceptance of long acting reversible contraceptive methods and factors associated with it among women of reproductive age. Methods: An institution based cross sectional study was conducted from February to march 2013. Among 348 family planning users and systematic sampling method was used to select the study participants. Interviewer administered structured questionnaire was used to collect data. Bivariate analysis was employed to determine predictors of acceptability of long acting contraceptives and variables which were found to be significant at P - values < 0.05 in bivariate analysis were taken to multivariate logistic regression to see the independent effects of the factors on the acceptability of long acting contraceptives. Result: The acceptability of long acting reversible contraceptive was 16.4%. The main reasons mentioned for not accepting long acting reversible contraceptive was developing side effects 128 (44.8%), and fear of infertility after use 117(40.9%). More than half 181 (52.9%) of the women had a non-supportive attitude towards long acting contraceptives. Mothers who had a supportive attitude towards long acting reversible contraceptive was the only independent predictors of acceptability of long acting contraceptive (AOR=2, 95% CI (1.084, 3.75). Conclusions: The acceptance of long acting reversible contraceptives was very low. Supportive attitude towards long acting contraceptives was the only factors that affect acceptance of long acting contraceptive.
    Science Journal of Public Health. 07/2014; 2(4):239-245.


Available from
May 15, 2014