PREVALENCE AND DETERMINANTS OF MODERN CONTRACEPTIVE USE AMONG POSTPARTUM WOMEN IN SELECTED SECONDARY HEALTH CARE FACILITIES IN IBADAN, OYO STATE, NIGERIA

Abstract

Women of reproductive age especially postpartum women are exposed to the risk of pregnancies. Contraceptive use during the postpartum period would reduce rates of maternal and infant mortality by preventing unplanned, unwanted pregnancies and by spacing new pregnancies at least two years after the previous birth. This study determined the prevalence and determinants of modern methods of contraceptives use among postpartum women in Ibadan. The study was a descriptive cross-sectional survey which adopted a 3-stage sampling technique. Ibadan North, Ibadan South East, Ibadan South West Local Governrnent Areas (LGAs) were randomly selected from five LGAs in Ibadan metropolis and one secondary health care facility was randomly selected from each of these LGAs. On the whole, 444 Postpartum Women (PW) were consecutively recruited into the study. A semi-structured interviewer administered questionnaire was used to elicit information on socio-demographic characteristics, knowledge of Modem Contraceptive Methods (MCMs), contraception practice within one year of delivery, (MCMs) and intention to use contraceptives within one year of delivery. Knowledge was measured on a 10-point scale with scores < 5 and ≥ 5 classified as poor and good respectively. Descriptive statistics, Chi-square and logistics regression analysis were used to analyse the data at 5% level of significance. Mean age of the PW was 29.4 ± 5.1, 45.0% had tertiary education and 73.0% had one or two children Majority (66.8%) resumed menstruation within nine months of delivery. The proportion who reported the use of MCMs was 61.7%. The preferred MCMs used by respondents included male condom (52.3%), intra uterine contraceptive device (11.7%), pill (11.0%), injectables (8.8%) and emergency contraception (8.8%). Mean knowledge score on MCMs out of 10 points was 5.1 ± 2.4 and 57.7% had good knowledge of MCMs. The PW with good knowledge of MCMs were four times more likely to use MCMs than those with poor knowledge (OR=4.5, 95% CI=3.0-6.8). Also those that had resumed menstruation were about two times more likely to have used MCMs than those that had not (OR =1.9, 95% Cl = 1.3-2.9). Among those that were currently using MCMs, 12% complained of side effects including; heavy menstrual loss (41.7%), excessive weight gain (16.7%), severe uterine cramps (16.7%) and heavy menstrual bleeding (8.3%). Ninety five (61.7%) out of one hundred and fifty four that were not practicing MCM, had no intention to use any of the method. Reasons for non-use were fear of side effects (33.8%), desire to have more children (27.6%), husband's disapproval (22.9%), previous negative experience (6.2%) faith/religion's disapproval (5.2%) and friend's disapproval (4.3%). Determinants of intention to use MCMs included having tertiary education (OR= 2.1. 95% CI =1.1-4.3) and having at least three children (OR=3.0, 95% CI=1.1-5.0). Prevalence of modern contraceptive use was high among postpartum women. Mother's educational level and number of children were the key determinants of MCMs use. Intervention programmes should focus primarily on postpartum women with lower education levels and fewer numbers of children.