La contraception du post-partum : état des connaissances

Woman's contraceptive needs and preferences in the postpartum period: an Italian study

AIMS AND OBJECTIVES

To describe what puerperal women know about postpartum contraception and to identify their related needs and expectations.

BACKGROUND

Puerperal women face the problem of beginning or resuming contraception, the choice of the right method of contraception and the right time to start it. This choice becomes particularly important in case they breastfeed since the contraceptive method should not interfere with breastfeeding. Different factors, such as the level of knowledge women have about various contraceptive methods, their individual preferences or their desire to have a baby, can strongly influence this choice.

DESIGN

A cross-sectional study had been carried out within the period of six months, from November 2011-February 2012.

METHODS

Three hundred puerperal women were interviewed before their discharge from a Maternity Home. The women were asked for their personal characteristics, their maternity history, the information they had received, their knowledge and expectations about postpartum contraception and their intention to use contraception.

RESULTS

During pregnancy and postpartum, 45.5% of the women reported that they had received adequate information about contraception. Of these ones, 64.3% reported their intention to use contraception either to avoid pregnancy or to space out future births, even if they did not always have appropriate knowledge about fertility and the use of contraceptive methods during postpartum. During this study, we also discovered that women's intention to use contraception was proportional to their level of education.

CONCLUSION

Women need more and appropriate information about postpartum contraception, to make a conscious choice in relation to their needs and without putting their health at risk.

RELEVANCE TO CLINICAL PRACTICE

To promote awareness of the choices related to postpartum contraception, it is important to understand the personal characteristics that influence or hinder this choice. Midwives can play a very important role in informing women and in developing educational interventions to support a safe contraceptive choice.

[The postnatal contraception: upon 600 patients of whom 129 were postnatal controlled]

OBJECTIVE

To draw a parallel between the contraceptive methods prescribed in the post-natal ward and the contraceptive methods taken by patients during their postnatal visit.

PATIENTS AND METHODS

This piece of work draws information from a prospective 10 weeks study at a University Teaching Hospital post-natal ward on the contraception that is prescribed upon leaving the maternity ward and also at the time of the post-natal visit.

RESULTS

From the 600 cases studied, the analysis is about 129 patients reviewed in the post-natal visit. The percentage of loss was 78.5%. A hormonal contraceptive pill was prescribed to 73.5% of women (441 patients) after birth in which 63.5% had microprogestative pills. At the earliest, the IUD was given at about 5.4 weeks postpartum. At the time of the postnatal visit, compliance was bad for one third of women with either estrogen plus progestin methods, microprogestative or natural methods. Women who chose a barrier method were only 45.5% to follow this choice, the others left without contraception.

DISCUSSION AND CONCLUSION

The prescription of postpartum contraception was followed by only 66.6% of women. In order to prescribe a more effective contraceptive method, we must improve the prescriber's timing in sharing contraceptive information and completeness of the contraceptive methods offered.