Comparison of Depot Medroxyprogesterone Acetate and Postpartum Intrauterine Contraceptive Device in a Teaching Institute of Rural Bengal: A Longitudinal Cohort Study

Abstract

Introduction: Contraception is one of the proximate determinants of fertility and the most important predictor of fertility transition. Depot Medroxy Progesterone Acetate (DMPA) and Intrauterine contraceptive device share some common features- both are Long Acting and Reversible Contraceptives (LARC), but the mechanisms are different. DMPA is a noninvasive, hormonal manoeuvre IUCD is an invasive, nonhormonal one. Aim: To compare the acceptance and reasons for refusal or non-compliance between DMPA and Postpartum Intrauterine Contraceptive (PPIUCD). Materials and Methods: A longitudinal cohort study was done in which total of 110 post partum women (55 in each group) using either DMPA or IUCD were selected randomly and were interviewed and followed up for minimum of six months. Data (variables- number of candidates accepting or refusing PPIUCD or DMPA) from the questionnaires were entered in Microsoft Office Excel 2007 and was transferred to IBM SPSS software, version 20.0 (SPSS Inc. Chicago, IL, USA). Pearson’s Chi-square test was used for variables and p-values were calculated using to find out the statistical significance of the variables and p-value <0.05 was considered statistically significant. Results: The overall acceptance of DMPA (87.3%) was found to be much more than that of PPIUCD (63.6%). In respect to different age groups, the acceptances of both PPIUCD and DMPA were significantly higher in women of age group 21-25. In respect to parity, acceptance of PPIUCD was more in women with one child, whereas the acceptances of DMPA were almost similar in women with either one or two children. Women using PPIUCD, 36.4% refused to continue with the method, whereas only 12.7% of DMPA users refused further injections, the main reason for both the groups being the same irregular bleeding. Conclusion: The acceptance as well as compliance of DMPA as a method of postpartum contraception is much better than PPIUCD in women of this part of part of rural Bengal.