Exploring Postpartum IUD Utilization in Dharwad: Awareness, Acceptance, and Rejection

Background: Postpartum contraception was recognised as an effective evidence-based method for preventing unintended pregnancy, unsafe abortion, maternal morbidity, and mortality. The World Health Organisation recommended the postpartum intrauterine contraceptive device, inserted immediately after delivery. It is an effective, long-acting, and reversible method. However, the knowledge and acceptance of this method among women remained limited. This study explored awareness, acceptance immediately following delivery, and reasons for rejection of the postpartum intrauterine contraceptive device among recently delivered women in rural and urban settings. Methods: A cross-sectional study was conducted in Dharwad district, Karnataka. Owing to restrictions during the coronavirus pandemic, 324 women who had recently delivered were interviewed by telephone using a pre-tested schedule. Data were collected with Kobo Toolbox and analysed with SPSS (version 28). Results: The study found that 61 percent of women were aware of the postpartum intrauterine contraceptive device, with significantly higher awareness in rural than in urban areas. Doctors and counsellors were the main sources of information in urban settings, while frontline health workers were the primary source in rural areas. Most women (88 percent) recognised the correct timing for insertion, but awareness of broader benefits was limited. Only 26 percent accepted the method after delivery. The main reasons for rejection were preference for other contraceptive methods (54 percent), fear of insertion or side effects (45 percent), and opposition from husbands or family members (29 percent). Conclusion: The study concluded that awareness of postpartum intrauterine contraceptive devices and their benefits must be strengthened. Comprehensive counselling should begin at the first antenatal visit to ensure informed choices among eligible women. Keywords: Postpartum Intrauterine Device (PPIUCD), Contraceptive Acceptance, Maternal Health, Awareness and Rejection, and Dharwad District