Frequency and Trend of Contraception Services during the COVID 19 Pandemic; A Two-Year Retrospective Analysis at A Tertiary Care Hospital

Abstract

Objectives: To examine the effect of the pandemic on postpartum contraceptive utilization among women who attended antenatal clinics at a tertiary care public hospital in Pakistan. The secondary aims of the study were to evaluate different types of postpartum contraceptive services utilized and determine factors affecting utilization of contraceptive services.

Methodology: This retrospective study was conducted at the Department of Gynecology and Obstetrics, Federal Government Polyclinic Hospital, Islamabad. The study participants were pregnant women who delivered in the hospital or it’s attached maternal and child health dispensary from January 2019 to December 2021. They were divided into two groups: pre-pandemic and pandemic. The pre-pandemic group included deliveries in 2019, while the pandemic group included deliveries from April 2020 to December 2021.The primary outcome variable was adoption of contraceptive method, whether immediately or up to 3 months postpartum. Pre-pandemic and Pandemic groups were compared for the utilization of postpartum contraception. Differences in types of contraceptive method used and factors associated with contraceptive use were also examined.

Results: A total of 5797 patients were included in the study, with 2837 in the pre-pandemic group and 2960 in the pandemic group. The contraceptive uptake rate was 38.2% in the antenatal patients adopting the contraceptive in the immediate or interval postpartum period in the pre pandemic period. The rate declined to 26.9% during the pandemic period. Intrauterine contraceptive device (IUCD) was the most prevalent method of contraception among both groups. However, women in the pandemic group were significantly more likely to have immediate postpartum insertion than those of the pre-pandemic group. The use of oral contraceptive pill was significantly reduced.

Conclusion: The contraceptive uptake rate in postpartum patients declined in the COVID pandemic period. But following the first COVID peak wave and partial lockdown period, the immediate IUCD was most prevalent method adopted by the patients, followed by the injectable progesterone method.