Feasibility, acceptability, and uptake of postpartum intrauterine contraceptive devices in southern Nigeria

Objective To evaluate the effect of postpartum intrauterine contraceptive device (PPIUD) implantation on existing low contraceptive uptake and utilization in Nigeria. Methods A prospective analytical cohort study was conducted at eight medical facilities in southern Nigeria between June 1, 2014 and May 31, 2015. Patients undergoing delivery during the study period were considered for eligibility and the exclusion criteria included any contraindications to PPIUD implantation. Following counselling, participants underwent PPIUD insertion within either 10 minutes (post-placental) or 48 hours (immediate) of delivery, or at cesarean delivery. All participants were scheduled to attend 14-day and 6-week follow-up. The primary outcome measure was the PPIUD-uptake rate and secondary outcome measures included patient satisfaction and complication rates. Results There were 1061 deliveries recorded during the study period; 746 patients were offered PPIUDs, with 374 (50.1%) accepting and undergoing insertion. Immediate post-partum insertion was performed for 199 (53.2%) participants, with 169 (45.2%) and 6 (1.6%) undergoing post-placental and intra-cesarean insertion, respectively. Conclusion PPIUD was safe and acceptable to Nigerian women. Increasing the education of patients and training of healthcare providers is recommended to scale-up PPIUD use in Nigeria.