A total of 408 randomly selected normally delivered women who had given birth to healthy infants were recruited from a postnatal ward at the University Teaching Hospital (UTH) in Lusaka, Zambia. Family planning practices before and after pregnancy and delivery were investigated among 376 of these women. The interviews were conducted in their homes or at the postpartum clinic at the UTH at the end of puerperium. The remaining 32 women, mainly primiparae, were lost to follow-up. Thirty four percent of the women had used a family planning method before the present childbirth. Most of those (90%) had used modern methods. Women with eight and more years of education used modern contraceptive methods more often than those with less education. One year after delivery, 64% of the women were using modern or traditional family planning methods. Of those who used traditional methods, 15% relied on lactational amenorrhoea. Of those who did not use any method, 39% indicated that their husbands did not allow them. Fifty-six per cent of the teenagers stated that they had no knowledge of family planning, whereas 84% of the single teenagers had not used contraceptives before. In view of this, teenagers and single mothers need a special focus in the development of family planning programmes. We also recommend that more research should focus on views of both men and women on contraceptive use.
PIP: This article presents an analysis of contraceptive usage before and after childbirth among 376 women (out of a total of 408 randomly selected women) delivering at the University Teaching Hospital in Lusaka, Zambia, during 1989-90. 90% of the original 408 women were married and living with their husbands. 75% lived in the high-density districts of Lusaka. 60% were housewives, and 22% had regular wage employment. 80% of husbands had regular paid employment. 66% reported knowledge of at least one contraceptive method; 34% had no contraceptive knowledge. 97% of those with some knowledge knew about modern methods. 56% of adolescents were unaware of any contraceptive method. 67% did not use any contraceptives. Of the 33% who used a method, 90% used a modern one. 84.4% of unmarried teenagers had not used contraceptives before the study. 58.4% stopped contraceptive use in order to conceive. After 1 year, 64% of 309 women were using contraceptives, of which 55% used a modern method. The most commonly used method was the pill. 17% of the 89 women who used traditional methods relied on lactational amenorrhea. 92% were still breast feeding (2-11 feeds in a 24-hour period) at the end of a year. 47% were menstruating. 68% had resumed sexual relations. 39% of the women at the end of the year who did not use contraception reported that husbands did not allow this practice. 22 women reported that their infant died within the year. Women with 8 or more years of education were more likely to use modern contraception. Contraceptive knowledge and use was influenced by parity, education, marital status, and age. Women mainly asked about what contraceptive methods were available, when to start use, and where to obtain contraception.