Skip to main content

Advertisement

SpringerLink
Log in

Impact of Structured Counseling on Choice of Contraceptive Method Among Postpartum Women

  • Original Article
  • Published:
The Journal of Obstetrics and Gynecology of India Aims and scope Submit manuscript

Abstract

Background of the Study

In India, although a number of contraceptive choices are available, the usage of contraceptive methods among postpartum women is rather low. The current study intended to determine the impact of “structured contraception counseling” on women’s decision making on selection of contraceptive methods and the reasons behind the selection of a contraceptive method.

Methods

One-hundred-and-seventeen postpartum women in the age group of 18–35 years, requesting contraception, were enrolled in the study. “Structured contraception counseling” was provided using a standardized protocol with balanced and comprehensive education material on the available hormonal and nonhormonal contraceptive methods. Questionnaires with information on the women’s pre- and post-counseling contraceptive choice, her perceptions, and the reasons behind her postcounseling decision were filled by the participating women.

Results

Maximum women enrolled for the study were in the age group of 21–25 years. In pre-counseling, 36 % postpartum women selected a contraceptive method, 23.1 % a nonhormonal method, and 12.8 % a hormonal method. After “structured contraception counseling,” 92.25 % of women chose a contraceptive method. There were significant differences between the women’s choices of contraceptive methods in the pre- and post-counseling sessions, respectively [progesterone-only pills (POP): 5.1 vs. 38.46 %, (p < 0.001); injectable-depot medroxy progesterone acetate (DMPA): 2.56 vs. 21.356 %, (p < 0.01); and intra uterine device (IUD): 10.28 vs. 23.92 %, (p < 0.001). 38.46 % chose a POP, 21.36 % injectable-DMPA, and 23.9 % the IUD].

Conclusion

“Structured contraception counseling” using standardized protocol resulted in significant improvements in the selection of contraceptive methods by postpartum women.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5

Similar content being viewed by others

References

  1. World Health Organization (WHO). Maternal mortality in 2005: estimates developed by WHO, UNICEF, UNFPA and the World Bank. Geneva: WHO; 2007.

    Google Scholar 

  2. Shah IH, Say L. Maternal mortality and maternity care from 1990 to 2005: uneven but important gains. Reprod Health Matter. 2007;15(30):17–27.

    Article  Google Scholar 

  3. Vernon R. Meeting the family planning needs of postpartum women. Stud Fam Plan. 2009;40(3):235–45.

    Article  Google Scholar 

  4. Kunwar S, Faridi MM, Singh S, et al. Pattern and determinants of breast feeding and contraceptive practices among mothers within six months postpartum. Biosci Trends. 2010;4(4):186–9.

    PubMed  Google Scholar 

  5. Whitworth A, Stephenson R. Birth spacing, sibling rivalry and child mortality in India. Soc Sci Med. 2002;55(12):2107–19.

    Article  PubMed  Google Scholar 

  6. Nath DC, Land KC, Singh KK. The role of breast-feeding beyond postpartum amenorrhoea on the return of fertility in India: a life table and hazards model analysis. J Biosoc Sci. 1994;26(2):191–206.

    Article  CAS  PubMed  Google Scholar 

  7. Sebastian MP, Khan ME, Kumari K, et al. Increasing postpartum contraception in rural India: evaluation of a community-based behavior change communication intervention. Int Perspect Sex Reprod Health. 2012;38(2):68–77.

    Article  PubMed  Google Scholar 

  8. Arora YL, Sharma GD. Family planning through post-partum communication in Dufferin Hospital, Lucknow. POPCEN News Lett. 1977;3(4):9–14.

    CAS  Google Scholar 

  9. Hingorani V. Methods of birth control. Choice is yours. Yojana. 1984;28(19):33–4.

    CAS  PubMed  Google Scholar 

  10. Machado RB, Pompei LM, Giribela A, et al. Impact of standardized information provided by gynecologists on women’s choice of combined hormonal contraception. Gynecol Endocrinol. 2013;29(9):855–8.

    Article  PubMed  Google Scholar 

  11. Sheriar N, Joshi R, Mukherjee B, et al. Impact of counseling on selection of hormonal contraceptive among Indian women, vol. 57. In: 18th world congress on controversies in obstetrics, gynecology and infertility, Vienna, 2013; pp. 24–27.

  12. International Institute for Population Sciences (IIPS) and Macro International, National Family Health Survey (NFHS-3), 2005–2006. India, vol. 1, Mumbai: IIPS, 2007.

  13. Smith R, Ashford L, Gribble J, et al. Family planning saves lives. Washington, DC: Population Reference Bureau; 2009.

    Google Scholar 

  14. Conde-Agudelo A, Belizan JM. Maternal morbidity and mortality associated with inter-pregnancy interval: cross sectional study. Br Med J. 2000;321(7271):1255–9.

    Article  CAS  Google Scholar 

  15. Collumbien M, Gerressu M, Cleland J. Non-use and use of ineffective methods of contraception. In: Comparative quantification of health risks: global and regional burden of disease attributable to selected major risk factors. Geneva: World Health Organization, Chapter 2004; 15:1255–320.

  16. Sheriar N, Joshi R, Mukherjee B, et al. Impact of structured counseling on the selection of hormonal contraceptive methods: results of a multi-centric, observational study in India. J Obstet Gynecol India. 2014;64(4):241–50.

    Article  CAS  Google Scholar 

  17. Goel S, Bhatnagar I, Khan ME, et al. Increasing postpartum contraception in rural Uttar Pradesh. J Fam Welf. 2010;56:57–64.

    Google Scholar 

  18. Cross2. United Nations, Department of Economic and Social Affairs, Population Division. 2011. World Contraceptive Use 2010 (POP/DB/CP/Rev2010). http://www.un.org/esa/population/publications/wcu2010/WCP_2010/Data.html. Accessed 2 June 2013.

  19. Yeshaya A, Ber A, Seidman DS, et al. Influence of structured counseling on women’s selection of hormonal contraception in Israel: results of the CHOICE study. Eur J Contracept Reprod Health Care. 2012;17:65–78.

    Article  Google Scholar 

  20. Tomaszewski J, Paszkowski T, Dębski R, et al. CHOICE (Contraceptive Health Research of Informed Choice Experience). Ginekol Pol. 2012;83:417–23.

    PubMed  Google Scholar 

  21. Baveja R, Buckshee K, Das K, et al. Evaluating contraceptive choice through the method-mix approach. An Indian Council of Medical Research (ICMR) task force study. Contraception. 2000;61:113–9.

    Article  CAS  PubMed  Google Scholar 

  22. Lete I, Doval JL, Perez-Campos E, et al. Factors affecting women’s selection of a combined hormonal contraceptive method: the TEAM-06 Spanish: sectional study. Contraception. 2007;76:77–83.

    Article  PubMed  Google Scholar 

  23. Zapata LB, Murtaza S, Whiteman MK, Jamieson DJ, Robbins CL, Marchbanks PA, D’Angelo DV, Curtis KM. Contraceptive counseling and postpartum contraceptive use. Am J Obstet Gynecol. 2015;212(2):171.

  24. Polus S, Lewin S, Glenton C, Lerberg PM, Rehfuess E, Gülmezoglu AM. Optimizing the delivery of contraceptives in low- and middle-income countries through task shifting: a systematic review of effectiveness and safety. Reprod Health. 2015;12(1):27.

Download references

Acknowledgments

This study is part of an Indian Council of Medical Research short-term studentship (ICMR STS -2014) Project. (Ref ID: 2014-00084).

Author information

Authors and Affiliations

  1. MGM Medical College, Navi Mumbai, India

    Harpreet Kaur Chhabra (Third year MBBS Student)

  2. Department of Pharmacology, Mahatma Gandhi Mission Medical College, Kamothe, Navi Mumbai, 410 218, Maharashtra, India

    Ipseeta Ray Mohanty (Professor) & Y. A. Deshmukh

  3. Department of Pediatrics, Mahatma Gandhi Mission Medical College Hospital for Women and Children, Kalamboli, Navi Mumbai, Maharashtra, India

    Nimain C. Mohanty

  4. Department of Obstetrics and Gynecology, Mahatma Gandhi Mission Medical College Hospital for Women and Children, Kalamboli, Navi Mumbai, Maharashtra, India

    Pratima Thamke

Authors
  1. Harpreet Kaur Chhabra
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Ipseeta Ray Mohanty
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Nimain C. Mohanty
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Pratima Thamke
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Y. A. Deshmukh
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Ipseeta Ray Mohanty.

Ethics declarations

Conflict of interest

The authors declare that there is no Conflict of Interest in the present study.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Additional information

Harpreet Kaur Chhabra is a student at MGM Medical College; Dr. Ipseeta Ray Mohanty is a Professor of Pharmacology at Mahatma Gandhi Mission.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Chhabra, H.K., Mohanty, I.R., Mohanty, N.C. et al. Impact of Structured Counseling on Choice of Contraceptive Method Among Postpartum Women. J Obstet Gynecol India 66, 471–479 (2016). https://doi.org/10.1007/s13224-015-0721-x

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s13224-015-0721-x

Keywords

Search

Navigation