Timing of Family Planning Counseling Linked to Postpartum Contraceptive Use in Uttar Pradesh, India

Providing family planning counseling to women while they are at a health facility to give birth may increase uptake of contraceptive methods in the year following childbirth, according to a recent study in Uttar Pradesh, India. "Counseling During Maternal and Infant Health Visits and Postpartum Contraceptive Use in Uttar Pradesh, India," by Sowmya Rajan of the University of North Carolina, Chapel Hill, et al., explores the link between postpartum contraceptive use and provision of family planning counseling at three points: during pregnancy, at the time of a visit to a health care facility to give birth and after childbirth.

Previous studies have shown that in the year following childbirth, many women want to postpone or avoid further births, but do not use a contraceptive method. Provision of family planning counseling and methods during this period can improve maternal and infant health by helping women achieve longer intervals between births. It is critical to understand how and when women are obtaining information on the risks of getting pregnant soon after childbirth—and on how to prevent pregnancy—to gauge the effectiveness of current family planning programs and make recommendations for improving these efforts.

The study was conducted in six cities in Uttar Pradesh, India’s most populous state and one of the least developed. Researchers analyzed the experiences of 2,733 women who gave birth between 2011 and 2014. The majority were 20–29 years of age, and 89% had at least two living children. Only about half (46%) had used a modern contraceptive method in the 12 months following their last birth.

Of women who gave birth at a health care facility, those who received family planning counseling while at the facility were twice as likely as those who received none to adopt a modern contraceptive method (rather than no method). Likewise, new mothers who received home visits from community health workers trained to counsel women on infant care and contraception were more likely to use modern contraception if they received family planning counseling during the visit than if they did not. Moreover, women who received counseling during postpartum visits from community health workers were more likely to choose temporary methods rather than sterilization. Counseling during prenatal health visits was not associated with postpartum contraceptive use.

The researchers recommend that programs in urban India seeking to increase postpartum use of modern contraceptive methods should consider delivery at health facilities and postpartum maternal and infant health visits as valuable opportunities for counseling on family planning and methods.

"Counseling During Maternal and Infant Health Visits and Postpartum Contraceptive Use in Uttar Pradesh, India," by Sowmya Rajan et al., appears in International Perspectives on Sexual and Reproductive Health and is currently available online.


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