Abstract of Dissertation

Keyword : Utilization of PPIUCD; PPIUCD services; Family Planning

Recommendations : Most women do not desire a pregnancy immediately after delivery but are unclear about contraceptive usage in the postpartum period. This results in unplanned and undesired pregnancies, which results in maternal morbidity and mortality and increases unsafe abortion rates. Continuation of these pregnancies is also associated with greater maternal complications and adverse perinatal outcomes. Post-partum family planning can be initiated as soon as delivery, depending on the type of contraception chosen by the woman. Early resumption of sexual activity coupled with an early and unpredictable return of fertility which can be as early as 4 weeks leads to many unwanted pregnancies in the first year postpartum. Thus, immediate postpartum family planning services need to be emphasized wherein the woman leaves the hospital with effective contraception as per her desire With recent additions of newer contraceptives in the public health system, the basket of choice has increased for the community. Technological advances, improved quality, and coverage for healthcare have resulted in a rapid fall in the Crude Birth Rate (CBR), Total Fertility Rate (TFR) and growth rate (2011 Census showed the steepest decline in the decadal growth rate.) It is well established that long-acting reversible contraception (LARC) is an effective measure for reducing unintended pregnancies and IUCD is one of the most popular LARC methods. India in 2009-10 introduced PPIUCD to avert unintended pregnancies during the post-partum period. Despite all this advantage, we found that we are still standing at a mere 1.5% when we talk about the prevalence of PPIUCD in our country with total unmet needs for family planning as high as 12.9%. As per USAID ACCESS, 2009 study unmet needs of family planning is as high as 65% in the post-partum period. As per NFHS 4, total unmet need for family planning in MP is 12.1 and of spacing is 5.7. MP`s TFR of 2.3 is marginally higher than the country`s average of 2.2