Da Costa Vanessa, Ingabire Rosine, Sinabamenye Robertine, Karita Etienne, Umutoni Victoria, Hoagland Alexandra, Allen Susan, Mork Ellen, Parker Rachel, Mukamuyango Jeannine, Haddad Lisa, Nyombayire Julien, Wall Kristin M
Rwanda Zambia HIV Research Group, Atlanta, GA, USA.
Emory University, Atlanta, GA, USA.
Clin Med Insights Reprod Health. 2019 Dec 3;13:1179558119886843. doi: 10.1177/1179558119886843. eCollection 2019.
The desire to space or prevent future pregnancies is high among postpartum women in Rwanda. However, the use of long-acting reversible contraception (LARC), especially the highly effective and cost-effective copper intrauterine device (IUD), is very low, whereas the rates of unintended pregnancy are high. This study aims to identify factors associated with pregnant women's and couple's interest in receiving a postpartum intrauterine device (PPIUD) within 6 weeks after delivery.
A total of 150 pregnant women or couples attending antenatal care (ANC) in Kigali, Rwanda participated in this cross-sectional study. After participating in a postpartum LARC counseling session, surveys assessed participants' demographics, pregnancy experiences and desires, and PPIUD knowledge, attitudes, practices, and interest. Multivariable logistic regression was used to model factors associated PPIUD interest within 6 weeks postpartum.
Although only 3% of women had ever used an IUD previously, 124 (83%) women were interested in receiving a PPIUD after counseling. Self-reporting physical side effects (adjusted odds ratio [aOR], 0.21; 95% confidence interval [CI], 0.06-0.75) and infection (aOR, 0.19; 95% CI, 0.04-0.85) as disadvantages to the IUD were significantly associated with no interest in receiving a PPIUD. Interest did not differ by male involvement.
Recommendations to increase PPIUD uptake include educating pregnant women and couples about the method during ANC and addressing client myths and misconceptions about the IUD. This strategy allows pregnant women and couples to make informed decisions about their future contraception use, reduce unmet need for family planning, and reduce unintended pregnancy.
卢旺达产后女性对生育间隔或预防未来怀孕的需求很高。然而，长效可逆避孕方法（LARC）的使用，尤其是高效且具成本效益的铜宫内节育器（IUD）的使用率非常低，而意外怀孕率却很高。本研究旨在确定与孕妇及其伴侣在分娩后6周内接受产后宫内节育器（PPIUD）的意愿相关的因素。
卢旺达基加利共有150名参加产前护理（ANC）的孕妇或夫妇参与了这项横断面研究。在参加产后LARC咨询会后，通过调查评估参与者的人口统计学特征、怀孕经历与意愿，以及对PPIUD的知识、态度、做法和意愿。采用多变量逻辑回归对产后6周内与PPIUD意愿相关的因素进行建模。
尽管此前只有3%的女性使用过IUD，但124名（83%）女性在咨询后有意愿接受PPIUD。自我报告IUD的身体副作用（调整优势比[aOR]，0.21；95%置信区间[CI]，0.06 - 0.75）和感染（aOR, 0.19；95% CI, 0.04 - 0.85）作为IUD的缺点与不接受PPIUD的意愿显著相关。意愿在男性参与方面没有差异。
提高PPIUD使用率的建议包括在ANC期间向孕妇及其伴侣介绍该方法，并消除客户对IUD的误解。这一策略能让孕妇及其伴侣就未来避孕方法做出明智决定，减少未满足的计划生育需求，并降低意外怀孕率。
