Navigating Postpartum Amenorrhea: Determinants and Implications for Maternal and Child Health in Rural Manipur

Postpartum amenorrhea (PPA) is a critical factor in determining birth intervals and has implications for maternal and child health. This study investigates the determinants influencing the duration of PPA among ever-married women in rural Manipur. A cross-sectional, community-based design was utilized, involving 729 participants from four valley districts, selected through cluster sampling. Data collection spanned from July 2022 to February 2023. The analysis incorporated survival analysis methods to account for censored data. Results indicated that the median duration of PPA was six months. A significant positive correlation was identified between PPA duration and breastfeeding duration (P<0.01). Additionally, infant mortality, especially the death of a previous child during infancy, was found to significantly affect the duration of amenorrhea. Socio-economic factors, including family income and religious affiliation – specifically Islam – also emerged as significant influences on PPA duration. These findings highlight the multifaceted nature of PPA where both biological and socio-economic determinants play critical roles. Understanding these factors is essential for developing strategies to improve maternal health outcomes and inform family planning practices in rural settings. The study underscores the importance of targeted interventions that consider breastfeeding practices and socio-economic conditions to effectively address the variations in PPA duration among women.