Barriers and Challenges in the Acceptance and Continuation of Postpartum Intrauterine Contraceptive Device

Abstract

Postpartum family planning (PPFP) interventions have immense potential to address the unmet contraceptive need in women from the time their baby is delivered till a variable period in their reproductive span. Postpartum intrauterine contraceptive device (PPIUCD) is one among the birth-spacing and birth-limiting contraceptive options. They have most attributes of an ideal contraceptive providing prolonged contraception akin to permanent contraceptives with scope of reversibility should the reproductive intentions of the couple change in future. This appeals to the societies and religious communities, who oppose permanent contraception. However, the acceptance and long-term continuation of the IUCD remains limited to and fails to total fertility rates (TFR) in populations who need it most. Global studies indicate this is often due to service providers’ adverse negative perception of PPIUCD, poor counseling skills, lack of technical skills in its insertion, and logistical limitations in various health facilities where deliveries occur, as well as the women’s and their family’s perspective about it rather than any intrinsic adverse characteristic of the device. The chapter is discourse about PPIUCD from multiple dimensions to define the barriers and challenges to its use in current practice. Interventions suggested may be incorporated into the national PPFP policy and program implementation as it is rolled out as a sustainable population control measure with far-reaching implications.