Reasons of Refusal to Postpartum Intrauterine Contraceptive Device

  • Rashida Sultana Assistant Professor, Department of Obstetrics & Gynaecology, Sharif Medical & Dental College, Lahore
  • Maimoona Hafeez Professor & Head of Obstetrics & Gynae Department, Sharif Medical & Dental College, Lahore
  • Nazia Badar Department of Obstetrics & Gynaecology, Sharif Medical & Dental College, Lahore
Keywords: Contraception, Intrauterine contraceptive devic, Postpartum


Objective: (1) To determine the reasons of refusal for insertion of postpartum intrauterine contraceptive device. (2) To determine the alternative contraceptive choices
Study design: Cross-sectional study
Duration and Place of Study: Obstetrics & Gynae Department of Sharif Medical City Hospital, Lahore, over a period of 6 months.
Methodology: Pregnant women of all age and parity attending antenatal clinic were counseled for insertion of the post-partum intrauterine contraceptive device. The women who refused for postpartum IUCD insertion were included in the study. Data was collected on a structured proforma and analyzed in SPSS 23. 
Results: Women recruited for the study were 434. Their mean age was 27.9±5.2 years and 60.8% (264) were multipara. The majority (58.1%) belong to low-income group.  Only 3.3% of male partner were illiterate and 11.5% of female but only 36.4% (158) had heard about postpartum insertion of intrauterine contraceptive device. Among women who declined to postpartum insertion of intrauterine contraceptive device, 28.6% (124) preferred to use alternative methods, 22.6% (98) were satisfied with their previous contraceptive method, 18% (78) were not willing to use contraception during puerperium and 12.4% (54) had fear of complications. The husband of study participants and their mother-in- law did not agree in 11% (48) and 1.4% (6) cases respectively. Couples who did not consent due to religious reasons were 3.2% (14) and 2.8% (12) had concerns about interference with the sexual activity. 
Conclusion: Major reasons of refusal for postpartum insertion of the intrauterine contraceptive device were women preference for alternative methods of contraception, their satisfaction with the previously used contraceptives and fear of complications in postpartum period. 

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