A prospective study to evaluate the efficacy and complications of post partum intra uterine contraceptive device insertion

Abstract

Background: India’s rising population poses a significant challenge the medical and healthcare facilities underscoring the need for effective postpartum contraceptive methods. Postpartum intrauterine contraceptive devices (PPIUCDs) are a safe, cost effective and long term contraceptives which are reversible, yet their acceptance remains suboptimal due to fear of complications, inadequate counselling and sociocultural factors. Objectives: To evaluate the efficacy, complications, acceptance and satisfaction related to postpartum intrauterine contraceptive device insertion among women consulting in a tertiary care hospital. Materials and Methods: This hospital-based prospective study was conducted in the Department of Obstetrics and Gynaecology at Mahatma Gandhi Medical College & Hospital, Jaipur, over 18 months, including 6 months of data collection and 12 months of follow-up. A total of 150 postpartum women who underwent PPIUCD insertion and consented to participate were included. Demographic characteristics, clinical outcomes, complications, discontinuation reasons, and satisfaction levels were analyzed using descriptive statistics and appropriate inferential tests, with p < 0.05 considered statistically significant. Results: Most participants were over 35 years of age, multiparous, and belonged to the middle socioeconomic class. Higher education and parity were significantly associated with better acceptance of PPIUCDs. Complications were infrequent, with abdominal pain (6.67%), infection (6%), expulsion (10.67%), and a single case (0.67%) of partial uterine perforation. The majority of women reported no pain or minimal discomfort following insertion. Desire for future conception was the most common reason for discontinuation. Overall, 25.33% of participants expressed satisfaction and willingness to continue PPIUCD use. Conclusion: PPIUCD is a safe, effective, and acceptable postpartum contraceptive method. Improved counseling, awareness, and provider training can further enhance its uptake and continuation.