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

Int J Gynaecol Obstet. 2015 Jun:130 Suppl 2:S54-61. doi: 10.1016/j.ijgo.2015.03.008.


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.

Keywords: Intrauterine device; Postpartum care; Postpartum family planning; Prenatal care; Program implementation.

MeSH terms

  • Adult
  • Ethiopia
  • Family Planning Services / statistics & numerical data*
  • Female
  • Guinea
  • Health Facilities / statistics & numerical data
  • Humans
  • Intrauterine Devices / classification*
  • Intrauterine Devices / statistics & numerical data*
  • Pakistan
  • Paraguay
  • Parturition
  • Patient Acceptance of Health Care / ethnology*
  • Philippines
  • Postpartum Period*
  • Rwanda
  • Young Adult