Background: The increasing number of cesarean sections is a leading cause of repeat cesarean section. This leads to a significant increase in risk factor for future obstetric morbidity and at times mortality in form of unintended pregnancy, over the counter use of medical abortion pills and other complications. In India, 65% of women in the first year postpartum have an unmet need for family planning. The traditional paradigm of starting contraception at a woman’s 6th week postpartum visit has been revolutionized, as the emphasis is shifting to providing women with the most effective methods as soon as possible in postpartum. This study is done to find out the acceptance of methods of family planning in patients undergoing repeat cesarean section.
Methods: Prospective longitudinal study for a period of one year in patients undergoing cesarean section at Department of Obstetrics and Gynecology at PCMS & RC, Bhopal.
Results: During the study period 48 patients underwent repeat cesarean section after recruitment and counseling for the methods of family planning. The mean age was 28.03 years. Majority of the patients 26 (64.17%) were in the age group of 23 to 28 years. 29 (60.42%) were gravida 2, parity 1. Although 100% patients were inclined to use some method of family planning, 33 (68.75%) accepted long term method of contraception in form of permanent method tubectomy 23 (47.92%) and 10 (20.94%) PPIUCD. The acceptance rate for use of long term method of contraception was significantly high in booked patients 27 (56.25%).
Conclusions: This study reveals good knowledge and favorable attitude of women towards contraception who are undergoing a repeat cesarean section. The acceptance of method of choice for family planning in patients undergoing repeat cesarean section is still permanent method in form of tubal ligation. Immediate post placental IUD insertion at the time of cesarean delivery is safe and acceptable. This can be used as alternate long term contraceptive method with antenatal counseling.