Prevalence, pattern and associated factors for long acting reversible contraceptive use among mothers in immediate postpartum period at Jimma University Medical Center: A cross sectional study

Abstract

Background: The provision of effective contraception is fundamental to the practice of women’s health care. Waiting at least for 24 months before attempting the next pregnancy was recommended to reduce the risk of adverse maternal, perinatal and infant outcomes. Long acting reversible contraception (LARC) methods have multiple advantages over other contraceptive methods. The most effective methods are intrauterine contraceptive devices (IUCD) and implants. Despite the advantages of LARCs, they are infrequently used in Ethiopia. Objective: To assess the prevalence, pattern and associated factors for LARC method use among counseled mothers in immediate postpartum at JUMC, Jimma town, southwest Ethiopia. Method: A cross-sectional study was conducted on 393 women who gave birth at JUMC from November 12, 2016 to January 21, 2017. Data collected by face-to-face interview and record review using pre-tested questionnaire and analyzed using SPSS 20. Logistic regression was used to identify associated factors for LARC use and the result was presented by text, tables and figures. Results: The overall prevalence of LARCs use among immediate postpartum mothers during study period was 53.2% (209/393) and more than three quarter (78.0%) of participants used implanon. The most common reported reasons for not using LARC were preference of other method (25.5%). Mothers who have more than four live kids were 2.6 times more likely to use LARCs than those only have one child (AOR=2.6 95% CI:1.15,5.95), those had monthly income of more than 1000 ETB were 2.4 times more likely to use LARCs (AOR=2.4,95% CI:1.08,7.20). Mothers who planned to extend next birth more 2-years were 3.8 times more likely to use LARC than mothers who planned within next two years (AOR=3.8, 95%CI:1.60,9.28) and those women who were completed family size were two fold more likely use of LARCs compared with those women need more child (AOR=1.9,95%CI:1.12,3.15). Mothers who had prior used LARC were three folds likely to use LARC than their counter parts (AOR=3.1, 95%CI: 1.30, 7.20) and mothers who ever counseled about LARCs before delivery were two fold likely to use LARCs (AOR =2.1:95%CI: 1.01, 4.73). Conclusion: In this study, there was high utilization of LARC methods among counseled immediate postpartum mothers. High monthly income, previous experience of LARC use, receiving counseling before delivery, more than four live kids, plan to delay next pregnancy more two years and completed family size were found to be determinant factors for current LARC use. The findings from the study highlight the need for providing and counseling service of LARC methods for all mothers during antenatal care follow up and delivery was high recommended