Publication:

Effect of dedicated antenatal counselling on insertion rate of post placental intrauterine contraceptive device

Background Post placental intrauterine contraceptive devices (PPIUCDs) are a safe, effective and long-acting reversible contraceptive method. However, their acceptance remains low due to limited awareness and prevailing misconceptions. Antenatal counselling offers an opportunity to improve acceptance. To assess the impact of dedicated antenatal counselling on PPIUCD acceptance and to evaluate knowledge, attitudes and factors influencing refusal among antenatal women.

Methods This facility-based prospective study was conducted among antenatal women delivering at a tertiary care centre. Participants received structured counselling during the third trimester and early labour. Data on awareness, perceptions, decision-making and acceptance of PPIUCD were collected and analysed statistically. Patients were followed up till delivery to see for acceptance of post placental IUCD.

Results Awareness of IUCDs was observed in 77.6% of participants. Following counselling, the acceptance rate of PPIUCD increased to 25.9% compared to 6.5% reported previously. Decision-making was predominantly influenced by husbands (50.4%). Major reasons for non-acceptance included fear of complications (22.6%), desire for more children (21.2%), preference for other methods (16.6%) and husband refusal (12.5%). Knowledge was significantly associated with factors such as age, education, occupation and gravidity (p<0.05).

Conclusions Dedicated antenatal counselling significantly improves PPIUCD acceptance by addressing misconceptions and enhancing awareness. Integrating repeated counselling into routine antenatal care and promoting partner involvement can further increase uptake and improve maternal health outcomes.