Evaluation of the relationship between pre-natal orientations regarding family planning and access to long-acting contraceptive methods during immediate puerperium at a low-risk maternity hospital in the metropolitan area of Curitiba

Abstract

ABSTRACT

Introduction: Knowledge and access to contraceptive methods for an adequate family planning during puerperium guarantee an appropriate inter-pregnancy interval, which reduces maternal and fetal risks. This must be transmitted to patients during prenatal care, and reinforced during hospitalization for delivery and during immediate and late puerperium. Objectives: To evaluate the impact of prenatal orientations over the choice of postpartum women to use contraceptive methods during puerperium; to determine the knowledge of postpartum women about which contraceptive methods can be used during the puerperium period and how much of this knowledge has been transferred during the prenatal; to relate the offering of access to long term contraceptive methods and the rate of insertion of IUD’s during immediate postpartum and post cesarean section in Alto Maracanã’s Maternity in the city of Colombo – PR. Methods: It is a descriptive, transversal and quantitative study. Data was collected through the application of a survey form to puerperal women at the maternity in question. The answers were analyzed by descriptive statistics. Results: In our sample, only 38.7% of pregnancies were planned, with no statistically relevant relation shown to factors such as age, marital status, education level, religion or monthly family income. Although most of the puerperal women had attended prenatal routine care, less than 50% received orientation about family planning during their medical appointments. 19.6% of patients had postpartum IUD insertion offered during prenatal care, and only 2.3% of the total sample had the IUD inserted during immediate postpartum. Pregnant women who were oriented about the possibility of postpartum IUD insertion during the prenatal period requested it 2.5 more times when compared to women who did not have the instruction about postpartum contraception. Conclusion:  There is a need for better assistance to family planning orientation during prenatal appointments in the city of Colombo – PR. Postpartum IUD insertion must be offered and, if chosen, correctly inserted by health care providers in both Basic and Specialized Attention. Explanations about contraceptive methods should be given to patients during prenatal care, so they have conscience about their options and rights to decide about their reproductive future.