Postpartum contraceptive use and unmet need for family planning in five low-income countries

Omrana Pasha, Shivaprasad S. Goudar, Archana Patel, Ana Garces, Fabian Esamai, Elwyn Chomba, Janet L. Moore, Bhalchandra S. Kodkany, Sarah Saleem, Richard J. Derman, Edward A. Liechty, Patricia L. Hibberd, K. Michael Hambidge, Nancy F. Krebs, Waldemar A. Carlo, Elizabeth M. McClure, Marion Koso-Thomas, Robert L. Goldenberg

Research output: Contribution to journalArticle

Abstract

Background: During the post-partum period, most women wish to delay or prevent future pregnancies. Despite this, the unmet need for family planning up to a year after delivery is higher than at any other time. This study aims to assess fertility intention, contraceptive usage and unmet need for family planning amongst women who are six weeks postpartum, as well as to identify those at greatest risk of having an unmet need for family planning during this period. Methods: Using the NICHD Global Network for Women's and Children's Health Research's multi-site, prospective, ongoing, active surveillance system to track pregnancies and births in 100 rural geographic clusters in 5 countries (India, Pakistan, Zambia, Kenya and Guatemala), we assessed fertility intention and contraceptive usage at day 42 post-partum. Results: We gathered data on 36,687 women in the post-partum period. Less than 5% of these women wished to have another pregnancy within the year. Despite this, rates of modern contraceptive usage varied widely and unmet need ranged from 25% to 96%. Even amongst users of modern contraceptives, the uptake of the most effective long-acting reversible contraceptives (intrauterine devices) was low. Women of age less than 20 years, parity of two or less, limited education and those who deliver at home were at highest risk for having unmet need. Conclusions: Six weeks postpartum, almost all women wish to delay or prevent a future pregnancy. Even in sites where early contraceptive adoption is common, there is substantial unmet need for family planning. This is consistently highest amongst women below the age of 20 years. Interventions aimed at increasing the adoption of effective contraceptive methods are urgently needed in the majority of sites in order to reduce unmet need and to improve both maternal and infant outcomes, especially amongst young women. Study registration: Clinicaltrials.gov (ID# NCT01073475)

Original languageEnglish (US)
Article numberS11
JournalReproductive Health
Volume12
Issue number2
DOIs
StatePublished - Jun 8 2015
Externally publishedYes

Fingerprint

Family Planning Services
Contraceptive Agents
Postpartum Period
Contraception Behavior
Pregnancy
Fertility
National Institute of Child Health and Human Development (U.S.)
Guatemala
Zambia
Intrauterine Devices
Kenya
Pakistan
Women's Health
Parity
Contraception
India
Mothers
Parturition
Education
Research

Keywords

  • Contraception
  • family planning
  • low-middle income countries
  • obstetric care

ASJC Scopus subject areas

  • Obstetrics and Gynecology
  • Reproductive Medicine

Cite this

Pasha, O., Goudar, S. S., Patel, A., Garces, A., Esamai, F., Chomba, E., ... Goldenberg, R. L. (2015). Postpartum contraceptive use and unmet need for family planning in five low-income countries. Reproductive Health, 12(2), [S11]. https://doi.org/10.1186/1742-4755-12-S2-S11

Postpartum contraceptive use and unmet need for family planning in five low-income countries. / Pasha, Omrana; Goudar, Shivaprasad S.; Patel, Archana; Garces, Ana; Esamai, Fabian; Chomba, Elwyn; Moore, Janet L.; Kodkany, Bhalchandra S.; Saleem, Sarah; Derman, Richard J.; Liechty, Edward A.; Hibberd, Patricia L.; Michael Hambidge, K.; Krebs, Nancy F.; Carlo, Waldemar A.; McClure, Elizabeth M.; Koso-Thomas, Marion; Goldenberg, Robert L.

In: Reproductive Health, Vol. 12, No. 2, S11, 08.06.2015.

Research output: Contribution to journalArticle

Pasha, O, Goudar, SS, Patel, A, Garces, A, Esamai, F, Chomba, E, Moore, JL, Kodkany, BS, Saleem, S, Derman, RJ, Liechty, EA, Hibberd, PL, Michael Hambidge, K, Krebs, NF, Carlo, WA, McClure, EM, Koso-Thomas, M & Goldenberg, RL 2015, 'Postpartum contraceptive use and unmet need for family planning in five low-income countries', Reproductive Health, vol. 12, no. 2, S11. https://doi.org/10.1186/1742-4755-12-S2-S11
Pasha, Omrana ; Goudar, Shivaprasad S. ; Patel, Archana ; Garces, Ana ; Esamai, Fabian ; Chomba, Elwyn ; Moore, Janet L. ; Kodkany, Bhalchandra S. ; Saleem, Sarah ; Derman, Richard J. ; Liechty, Edward A. ; Hibberd, Patricia L. ; Michael Hambidge, K. ; Krebs, Nancy F. ; Carlo, Waldemar A. ; McClure, Elizabeth M. ; Koso-Thomas, Marion ; Goldenberg, Robert L. / Postpartum contraceptive use and unmet need for family planning in five low-income countries. In: Reproductive Health. 2015 ; Vol. 12, No. 2.
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AU - Patel, Archana

AU - Garces, Ana

AU - Esamai, Fabian

AU - Chomba, Elwyn

AU - Moore, Janet L.

AU - Kodkany, Bhalchandra S.

AU - Saleem, Sarah

AU - Derman, Richard J.

AU - Liechty, Edward A.

AU - Hibberd, Patricia L.

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