Postpartum contraception: Where do we stand in 2024

Contraception is vital for reducing unwanted pregnancies and promoting healthy living among women. The postpartum period offers a unique opportunity to implement birth spacing strategies that can significantly improve maternal and infant health outcomes. Despite the availability of effective contraceptive methods, many women do not use contraception postpartum. This study aims to assess knowledge, attitude about post-partum contraception among post- partum women in Pune to identify gaps and barriers to effective contraceptive use. Maximum need of contraception is in post-partum period to prevent pregnancies in lactational amenorrhoea & to reduce risks related to short interpregnancy intervals. This cross-sectional study was conducted over six months at a tertiary care centre in Pune. It included 460 postpartum women aged 18-49 years who were interviewed one day before discharge. Data was collected using a structured questionnaire, capturing demographic details, awareness, attitudes, and practices related to contraception. Descriptive and inferential statistics were used to analyze the data. Chi-square tests were employed to determine associations between demographic factors and awareness and usage of contraception. Statistical significance was set at p<0.05. The majority of participants were aged 21-25 years (55%), from urban areas (51%), and practiced Hindu religion (89%). Awareness of at least one contraceptive method was high (90%), with sterilization (88%), condoms (80%), and intrauterine devices (70%) being the most known methods. However, only 70% used any form of contraception, with condoms and IUDs being the most commonly used (20% each). The primary reasons for non-usage included fear of side effects (32%), family objections (22%), and lack of awareness (17%). Significant differences in awareness and usage were found based on residential area, education level, and parity, but not on religion or occupation. The study highlights a significant gap between high awareness and the lower practice/ willingness of contraceptives among postpartum women in Pune, with disparities driven by factors such as urban residency, education, and parity. Fear of side effects, family objections, and lack of awareness were key barriers to contraceptive uptake. To address these issues, targeted health education, particularly in rural areas, and inclusive counselling sessions involving partners and families are essential. By overcoming these barriers, contraceptive usage can be increased, ultimately improving maternal and infant health outcomes in the region.