Publication:

Impact of COVID-19 pandemic on postpartum contraception services in women delivering at a tertiary care centre in South India

Background Contraception and sexual health are a fundamental human right and an integral part of women’s health services. Postpartum period is the unique opportunity for counselling and availing contraception. COVID-19 pandemic hindered routine and special services like postpartum clinics has negative impact on family planning services. Objectives were to assess the effect of the COVID-19 pandemic on postpartum contraceptive care services received and to describe the challenges faced in availing these services among pregnant women delivering at a tertiary care centre in South India.

Methods A descriptive study carried out in 422 women who had delivered at our hospital from July 2020 to October 2020. Data was collected in Epicollect version 5 and analysed using Stata version 14.2.

Results A total of 422 women were interviewed. Only one-third of the participants received contraceptive counselling in the antenatal period compared to 90% postpartum. 39% (primiparous-34%/multiparous-5%) had adopted barrier methods followed by post-partum intrauterine uterine contraceptive devices in 33% (primiparous-19.6%/multiparous-13.4%) and 5% had sterilisation concurrent with caesarean section. Around 30-40% of women faced challenges in accessing the family planning methods due to closure of elective services like postpartum clinics, operation theatres, nationwide lockdown, and non-availability of field health workers.

Conclusions Contraceptive choices for postpartum women appear to be largely restricted to temporary methods with additional challenges of availing these services during the pandemic. With the ongoing COVID-19 crisis and continuous need for contraception, there is a need to refocus and motivate eligible couples for long-acting reversible contraceptive methods (LARC) with significantly lower failure rates.