Effect of Family Planning Counseling After Delivery on Contraceptive Use at 24 Weeks Postpartum in Kinshasa, Democratic Republic of Congo
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Introduction Unintended pregnancy during the postpartum period is common. The aim of this study was to describe contraceptive use among postpartum women and assess whether family planning counseling offered by health care providers during well-baby clinic visits increased use of modern contraceptive methods at 6 months following delivery. Methods Data comes from a cohort of women enrolled in a breastfeeding promotion trial in Kinshasa, Democratic Republic of Congo who reported being sexually active at 24-weeks post-partum. Modern contraceptive methods included intrauterine devices, injectables, implants, and contraception pills. Logistic regression models were used to estimate odd ratios (OR) and 95% confidence intervals (CI) for the impact of nurse counseling on use of modern birth control methods. Results Of 522 participants who reported being sexually active, 251 (48.0%) reported doing at least one thing to avoid pregnancy and were included in this analysis. Of these 251, 14.3% were using a modern contraceptive method, despite availability at the clinic. Discussion with a nurse about family planning was associated with increased odds of using modern birth control relative to other methods (OR 4.0, 95% CI 1.9, 8.6). Discussion Discussion of family planning with a nurse increased the odds of using a modern contraceptive among postpartum women. Integration of family planning counseling into postpartum services offers a potential avenue to increase modern contraceptive use among women with access.
KeywordsPostpartum Contraceptive use Family planning counselling Well-baby clinics DR Congo
We are grateful for the participation and time of the study mothers and infants; the time and efforts of the personnel of the participating clinics (Esengo, Kikenda, Kitega, Libikisi, Lukunga, and Luyindu); the technical support of Drs. Aimee Lulebo, Dinah Kayembe, Landry Kiketa, Jean Lambert S. Chalachala, Mrs. Kathryn Salisbury, and Deidre Thompson; the data collection and data entry contributions of Clever Akili, Dyna Anambatu, Valerie B. Chalachala, Marie Dauly, Dydy Kayembe, Mamie Lulebo, Fanny Matadi, Myriam Mbonze, Espérance Mindia, Sarah Mushiya, Gisèle Mvumbi, Dodo Mwela, Jolly Ntirume, Ros Samba; and the administrative support of the UNC, KSPH, and Alive & Thrive administrative teams.
The original trial was supported by a grant from the Bill & Melinda Gates Foundation to FHI 360, through the Alive & Thrive Small Grants Program managed by UC Davis via a sub-award to the University of North Carolina at Chapel Hill. MY is partially supported by the NIAID U01AI096299-01 and the NICHD R01HD087993. The sponsors of the study had no role in study design, data collection, data analysis, data interpretation, writing of the report, or the decision to submit the paper for publication. PNZ is supported by NICHD T32-HD091058.
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