A facility birth can be the time to start family planning: Postpartum intrauterine device experiences from six countries

Anne Pfitzer, Devon MacKenzie, Holly Blanchard, Yolande Hyjazi, Somesh Kumar, Serawit Lisanework Kassa, Bernabe Marinduque, Marie Grace Mateo, Beata Mukarugwiro, Fidele Ngabo, Shabana Zaeem, Zonobia Zafar, Jeffrey Smith

Research output: Contribution to journalArticle


Initiation of family planning at the time of birth is opportune, since few women in low-resource settings who give birth in a facility return for further care. Postpartum family planning (PPFP) and postpartum intrauterine device (PPIUD) services were integrated into maternal care in six low- and middle-income countries, applying an insertion technique developed in Paraguay. Facilities with high delivery volume were selected to integrate PPFP/PPIUD services into routine care. Effective PPFP/PPIUD integration requires training and mentoring those providers assisting women at the time of birth. Ongoing monitoring generated data for advocacy. The percentages of PPIUD acceptors ranged from 2.3% of women counseled in Pakistan to 5.8% in the Philippines. Rates of complications among women returning for follow-up were low. Expulsion rates were 3.7% in Pakistan, 3.6% in Ethiopia, and 1.7% in Guinea and the Philippines. Infection rates did not exceed 1.3%, and three countries recorded no cases. Offering PPFP/PPIUD at birth improves access to contraception.

Original languageEnglish (US)
Pages (from-to)S54-S61
JournalInternational Journal of Gynecology and Obstetrics
Issue numberS2
Publication statusPublished - Jun 1 2015
Externally publishedYes



  • Intrauterine device
  • Postpartum care
  • Postpartum family planning
  • Prenatal care
  • Program implementation

ASJC Scopus subject areas

  • Obstetrics and Gynecology

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