Jisha Bai C. P1

BACKGROUND: More than half of Indian women in the first year post-partum wish to use a family planning method, but only one fourth is utilizing any method. This study was done to assess the complications of immediate postpartum insertion of intrauterine contraceptive device with the aim to offer a more effective postpartum family planning method.

STUDY SETTING: Institute of Maternal and Child health, Government medical college, Kozhikode.

STUDY DESIGN: A prospective longitudinal study.

METHODS: The women who choose to have a postpartum intrauterine device insertion (Cu T 380A) were counseled and device inserted within 48hrs postpartum. Follow up is done from immediate postpartum period to 6 months for complications and client satisfaction.

RESULTS: Of the 100 subjects in the study group, there were 68 intracaeserean insertions and 32 transvaginal insertions. Expulsion of the device was found to be a significant complication in this study. The total expulsion rate was 3% in the whole study group. There was no expulsion in the subjects who had intracaeserean insertion. All the expulsions were among those in the transvaginal route, which was 9.4% (p value, 0.031). At the end of six months follow up, of the total 91% of the subjects who continued with this method, thread of the device was not visible in 25.3%. In situ device was confirmed by ultrasonography in such cases. 89% of the women were satisfied with this method of family planning with intracaeserean insertion leading to more client satisfaction (p value 0.034).

CONCLUSIONS: Immediate postpartum CuT 380A is a method of family planning with good client satisfaction especially intracaeserean insertion which had less expulsion rate than transvaginal.