Makins Anita, Bright Suzanna, Tunnacliffe Emily-Anne, Arulkumaran Sabaratnam
Nuffield Department of Women's and Reproductive Health, University of Oxford, Oxford, United Kingdom; Oxford University Hospitals NHS Trust, Oxford, United Kingdom; Committee on Contraception, International Federation of Obstetrics and Gynaecology, Theed Street, London, United Kingdom.
International Federation of Gynecology and Obstetrics, London, United Kingdom.
Best Pract Res Clin Obstet Gynaecol. 2025 Sep;102:102639. doi: 10.1016/j.bpobgyn.2025.102639. Epub 2025 Jul 14.
The global unmet need for contraception continues to be unacceptably high at 218 million. The vast majority of these are women living in low and middle income countries, with a particularly high unmet need in the postpartum period. The FIGO PPIUD initiative demonstrated that it is feasible to embed counselling on contraception and insertion of PPIUD in maternity services. Implementation of these services was greatly enhanced by ensuring that counselling was culturally sensitive and appropriately given through specifically trained individuals, that task sharing was maximized in order to increase access, and that a high fundal placement was achieved resulting in low expulsion rates. Financing for contraception in LMICs is currently precarious and vulnerable to international politics. PPIUD is highly cost-effective. Expansion of contraception services including PPIUD has the potential to impact positively on climate change and a country's development profile if expanded on a large scale.
全球避孕需求未得到满足的情况仍然高得令人无法接受，达2.18亿人。其中绝大多数是生活在低收入和中等收入国家的妇女，产后阶段的未满足需求尤其高。国际妇产科联盟（FIGO）产后即时宫内节育器（PPIUD）倡议表明，将避孕咨询和PPIUD植入纳入孕产妇服务是可行的。通过确保咨询具有文化敏感性并由经过专门培训的人员适当提供，最大限度地进行任务分担以增加可及性，并实现高宫底放置从而降低脱落率，这些服务的实施得到了极大加强。低收入和中等收入国家的避孕资金目前不稳定，容易受到国际政治的影响。PPIUD具有很高的成本效益。如果大规模扩大包括PPIUD在内的避孕服务，有可能对气候变化和一个国家的发展状况产生积极影响。
