Counseling During Maternal and Infant Health Visits and Postpartum Contraceptive Use in Uttar Pradesh, India
Women have a high unmet need for contraception in the year following a birth. It is important to examine whether providing family planning counseling as part of antenatal, intrapartum and postpartum maternal and infant health services is associated with postpartum contraceptive use.
Survey data from 2,733 women aged 15–49 from six cities in Uttar Pradesh, India, who had had a birth between 2011 and 2014 were used to examine associations between exposure to family planning information at maternal and infant health visits and contraceptive use in the postpartum period. Discrete-time event history multinomial logit models were used to examine any contraceptive use and method choice among modern method users in the 12 months following the last birth.
Forty-six percent of women reported having used a modern contraceptive in the 12 months following their last birth during the study period; another 18% had used a traditional method. Among women who had delivered at a health facility, those who had received family planning counseling at that time were more likely than others to have used a modern method postpartum rather than no method or a traditional method (relative risk ratios, 2.0 and 2.3, respectively). Receiving a postpartum home visit by a community health worker that included family planning counseling was positively associated with modern method use rather than use of no method (1.3).
Providing postpartum family planning counseling at the time of an institutional birth and during maternal health visits could increase women's uptake of a modern contraceptive method in urban Uttar Pradesh.
Sowmya Rajan is postdoctoral scholar, Ilene S. Speizer is faculty fellow and Lisa M. Calhoun is technical officer—all with the Carolina Population Center, University of North Carolina at Chapel Hill, USA. Priya Nanda is group director, International Center for Research on Women, New Delhi.