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Contraception. 2014 Jun;89(6):516-20. doi: 10.1016/j.contraception.2014.01.001. Epub 2014 Jan 10.

Postpartum contraception utilization among low-income women seeking immunization for infants in Mumbai, India.

Author information

  • 1Department of Reproductive Medicine, University of California, San Diego School of Medicine, San Diego, CA 92103, USA; Center on Gender Equity and Health, Division of Global Public Health, University of California, San Diego School of Medicine, San Diego, CA, USA. Electronic address: smody@ucsd.edu.
  • 2National Institute for Research on Reproductive Health, Mumbai, India.
  • 3Center on Gender Equity and Health, Division of Global Public Health, University of California, San Diego School of Medicine, San Diego, CA, USA; Joint Doctoral Program in Public Health (Global Health), University of California, San Diego/San Diego State University, San Diego, CA, USA.
  • 4Center on Gender Equity and Health, Division of Global Public Health, University of California, San Diego School of Medicine, San Diego, CA, USA.
  • 5Population Council, New Delhi, India.

Abstract

OBJECTIVE:

The objective was to examine postpartum contraception utilization among Indian women seeking immunization for their infants in three low-income communities in Mumbai, India.

STUDY DESIGN:

We conducted a cross-sectional questionnaire of low-income postpartum women seeking immunization for their infants at three large urban health centers in Mumbai. Contraceptive utilization data were collected as part of a larger study focused on the impact of postpartum domestic violence on maternal and infant health. Descriptive, bivariate and multivariate analyses were conducted to describe and identify predictors of postpartum contraceptive utilization.

RESULTS:

Postpartum women aged 17-45 years (N=1049) completed the survey; 44.5% (n=467) reported resuming sexual relations with their husbands. Among these women, the majority (65.3%; n=305) reported not currently using contraception. In multivariate analyses, women who did not discuss postpartum family planning with their husbands, had not used contraception previous to the recent birth, and had experienced physical violence or forced sex were more likely to not use postpartum contraception (adjusted odds ratios=1.47-1.77). Among the 162 women using contraception, the most common time to initiation of contraception was 5 weeks postpartum, and the most common method used was condoms 77.8% (n=126).

CONCLUSION:

Contraception nonuse was common among urban, low-income postpartum women in India. This study highlights the importance of developing interventions to increase use of highly effective contraceptive methods postpartum, and that spousal violence and lack of marital communication may present barriers to postpartum contraception utilization. Infant immunization may represent an opportunity for provision of contraceptives and contraceptive counseling.

IMPLICATIONS:

This original research study is a unique contribution to the literature because it presents data regarding the nonuse of postpartum contraception among women seeking immunizations for their infants in urban centers in a developing country. It also reveals barriers to not using postpartum contraception and provides data for future interventions.

Copyright © 2014 Elsevier Inc. All rights reserved.

KEYWORDS:

Birth-to-pregnancy interval; Contraception; Immunization; Postpartum

PMID:
24560478
[PubMed - indexed for MEDLINE]
PMCID:
PMC4264596
[Available on 2015-06-01]
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