Joshi Arun Kumar, Tiwari Dipak Prasad, Poudyal Anil, Shrestha Namuna, Acharya Uttam, Dhungana Govinda Prasad
Chitwan Medical College, Chitwan, Nepal.
Ministry of Health and Population, Kathmandu, Nepal.
Int J Womens Health. 2020 Jun 24;12:487-494. doi: 10.2147/IJWH.S249044. eCollection 2020.
Postpartum contraceptives use offers a distinctive opportunity to maintain appropriate birth spacing for health benefits to both mother and child. However, the concept of postpartum family planning (PPFP) is poorly understood and contraceptives use during the postpartum period remains low in Nepal. Therefore, this study aimed to assess the factors affecting the utilization of family planning (FP) methods among postpartum mothers in the Kailali district, Nepal.
A community-based cross-sectional study was conducted between September and October 2013 among postpartum mothers in Kailali district. Simple random sampling was applied to select a total of 427 study participants. A pre-tested standard semi-structured questionnaire was used for gathering data. Data were analyzed using Statistical Package for Social Sciences (SPSS) version 20.0.
Overall, 32.8% of the postpartum women used different types of contraceptives. Condoms (37.1%) followed by Depo-Provera 29.3% were the most used postpartum contraceptives. Half (50%) of the postpartum women had an unmet need for family planning. Multiple logistic regression model revealed that the occupation of husband [AOR=3.2 (95% CI: 2.0-6.00], past use of family planning methods [AOR=4.0 (95% CI:2.4-6.5)] and resumption of menstruation [AOR=2.5 (95% CI:1.6-4.1)] were significantly associated with the use of modern contraceptives during the first year of the postpartum period.
Contraceptive uptake within the first year of postpartum was found to be low among women in the Kailali district, Nepal. Previous experience with the use of family planning methods, occupation of the husbands, and resumption of menstruation are important factors in the PPFP decisions of women in this population. Therefore, the family planning program should work on improving couples' knowledge of the risk of pregnancy, fertility returning time and modern contraceptives use during the postpartum period targeting women whose husbands are in migrant occupations, who are not menstruating and who have not used FP before.
产后使用避孕药具为维持适当的生育间隔提供了独特机会，对母婴健康均有益处。然而，尼泊尔对产后计划生育（PPFP）的概念理解不足，产后时期避孕药具的使用率仍然很低。因此，本研究旨在评估影响尼泊尔凯拉利地区产后母亲使用计划生育（FP）方法的因素。
2013年9月至10月间，在凯拉利地区的产后母亲中开展了一项基于社区的横断面研究。采用简单随机抽样方法共选取了427名研究参与者。使用经过预测试的标准半结构化问卷收集数据。数据采用社会科学统计软件包（SPSS）20.0版进行分析。
总体而言，32.8%的产后妇女使用了不同类型的避孕药具。使用最多的产后避孕药具是避孕套（37.1%），其次是醋酸甲羟孕酮（29.3%）。一半（50%）的产后妇女有未满足的计划生育需求。多因素逻辑回归模型显示，丈夫的职业[AOR=3.2（95%CI：2.0-6.00）]、过去使用计划生育方法的情况[AOR=4.0（95%CI：2.4-6.5）]和月经恢复情况[AOR=2.5（95%CI：1.6-4.1）]与产后第一年使用现代避孕药具显著相关。
在尼泊尔凯拉利地区，产后第一年妇女的避孕药具使用率较低。过去使用计划生育方法的经历、丈夫的职业以及月经恢复情况是该人群中妇女产后计划生育决策的重要因素。因此，计划生育项目应致力于提高夫妇对产后怀孕风险、生育恢复时间以及现代避孕药具使用的认识，目标人群为丈夫从事移民职业、未恢复月经且以前未使用过计划生育方法的妇女。
