Evaluation of factors related to women's modern family planning needs in postpartum period

ABSTRACT EVALUATION OF FACTORS RELATED TO WOMEN'S MODERN FAMILY PLANNING NEEDS IN POSTPARTUM PERIOD AIM: In this study, we aimed to evaluate the factors related to modern family planning method requirements of married women aged 15-49 in postpartum period. MATERIAL AND METHOD Planned as a cross-sectional analytical study, the universe of this study consists of those women giving birth in the last year and registered to 75. Yıl, Alparslan and Cengizhan Districts. The sampling of the study consisted of 347 women out of total 363 women having given birth in the last year who were selected from the lists obtained from district representative's office. During home visits, these women were administered questionnaires consisting of a total of 86 questions about their views on the use of family planning methods, socio-demographic and fertility characteristics. Once they had been administered the questionnaire, a training brochure regarding "Modern Family Planning Methods" was left to their homes. The research was conducted with the permission obtained from of Ege University Faculty of Medicine Ethics Committee. Chi-square test was used in the evaluation of the relationship between the factors affecting their unmet requirements in the use of modern family planning methods in postpartum period among women and their socio-demographic, fertility characteristics and the way they received family planning counseling. FINDINGS: The proportion of women using any method in the postpartum period was70.9%, while 51.9% of them stated that they used modern methods, with 19% having stated to be using traditional methods. The proportion of women's unmet modern family planning needs in postpartum period was determined as 48.1%. 41.2% of women's pregnancies that resulted in birth occurred as unplanned. Out of those women who did not want to end up with pregnancy experienced an unplanned pregnancy while using: 16.8% condoms, 13.2% oral contraceptives and 2.1% intrauterine. It was determined that their husbands ranked first with the proportion of 43.9% affecting their family planning decisions and that one in every 5 women still did not use any kind of family planning methods since their husbands did not want. It was determined that 27.9% of women used intrauterine vehicle, 15.6% of them condoms, 8.1%, oral contraceptives, 0.3% of them tubal ligation and 19% of those women were protected relying on withdrawal method in the postpartum period. Unmet modern FP needs were found to be significantly lower among women with better income perception, under 30 years of age and higher education (p <0.05). FP needs were found to be significantly higher among the women in whose marriage decision their families had influences (p <0.05) Spouses higher level of unmet need for modern family planning than those in women who are under 30 years of age and over 30 years of age was found (p <0.05). A higher rate of unmet modern family planning needs was determined among those with a husband older than 30 or more compared to those whose husbands were younger than 30. The unmet need for modern FP proportion was found to be higher in those with a birth number less than three (p <0.05) The unmet need for modern FP was found to be higher in women who readily had abortion compared to those who never did during their childbearing age (p <0.05) It was also found that 5.5% of women never had any monitoring by family planning centers during their pregnancies. 51.3% of the women were found to have family planning counseling during their pregnancies and the frequency of this was state hospital with 33.1% and 27% counseling from the university hospital and midwifery students respectively. Of all women, only 7.9% of them received family planning counseling from primary care. We found that 10.4% of women had no monitoring in postpartum period, and of those monitored, 89.6% of them were monitored at least once by the Family Health Center. In the study group, the level of unmet modern FP need was found to be higher in those without any follow-up during postpartum period (p <0.05). Postpartum period, family planning counseling was provided to 35.7% of women both in the hospital and at home, about half of these women received counseling from primary care. Postpartum unmet modern family planning need was significantly higher in women who had no family planning counseling during pregnancy and postpartum period (p <0.05). Unmet modern family planning need was found to be lower in women who had family planning counseling from Family Health Centers during postpartum period (p<0.05). Unmet modern family planning need was found to be lower in women who had family planning counseling from midwives working in Family Health Centers (p <0.05). Results: The fact that 48.1% of women is not using any modern method of family planning in the postpartum period is an indication of their unmet need for family planning. The higher need for modern family planning in those who do not receive family planning counseling during pregnancy as well as the postpartum period and the fact that almost half of those receiving counseling receive the service from primary care are both the indications of the necessity and importance of primary care services. Also, when looked in terms of the fact that the unmet modern family planning need was lower among those receiving counseling from Health Care Centers and particularly from midwives, it can be said that giving priorities to family planning counseling that could be performed in primary care by midwives and planning the process in this way are both of great importance. Keywords: Postpartum Period, Family Planning, Modern Methods of Use, Unmet needs