Abstract:
Closely spaced unplanned pregnancy contributes to sigpificantly high adverse maternal and perinatal outcomes. In view of high rates of unintended pregnancy, particularly in postpartum women, there is a need for reliable, effective, reversible and long-term contraception for adequate spacing of pregnancy. In Sri Lankan hospital setting, sterilization is the only contraceptive method provided for postpartum mothers before discharge. This study was done to determine the evaluation of PPIUD services at an institutional level. A cross-sectional study was conducted at Teaching hospital Mahamodera for four years from June 2014. Both community and medical staff were trained on counseling and PPIUD insertion technique respectively. Antenatal mothers were counseled regarding postpartum contraception. PPIUDs were inserted for consented mothers following caesarean sections and vaginal deliveries. They were followed up to one year at community and hospital. Data were collected using pre tested validated interviewer administrated questionnaire. Questionnaire consisted of basic demographic data, insertion details and follow up information. Total number of deliveries were 46, 815 during the study period. Proportion of antenatal women counseled for post-partum family planning was 49% (n= 23, 117). Out of total counseled women 30% (n=14, 051) were educated regarding PPIUD. Only 1.7% of (n=772) women consented for PPIUD. Proportion of PPIUD insertion was 1 % (n=470). Low acceptance rate could be due to religious movements against contraception and attitudes towards consultants towards PPIUD. Rate of expulsion was 1.7% (n=8) during the follow up period of one year. Follow-up data were available for 25% (n = 119) of acceptors up to one year. Complication (heavy menstrual bleeding, abdominal pain and endometritis) rates were 1.7% (n = 8). There was no failure of PPIUD reported during the one year period of follow up. PPIUD was a safe and effective method of PPFP for post partum women. Introduction of PPIUD service at THM is feasible with further improvement of counseling service and making stream line of post insertion follow up.
