title: A facility birth can be the time to start family planning: postpartum intrauterine device experiences from six countries.
abstract: Initiation of family planning at the time of birth is opportune, since few women in low-resource settings who give birth in a facility return for further care. Postpartum family planning (PPFP) and postpartum intrauterine device (PPIUD) services were integrated into maternal care in six low- and middle-income countries, applying an insertion technique developed in Paraguay. Facilities with high delivery volume were selected to integrate PPFP/PPIUD services into routine care. Effective PPFP/PPIUD integration requires training and mentoring those providers assisting women at the time of birth. Ongoing monitoring generated data for advocacy. The percentages of PPIUD acceptors ranged from 2.3% of women counseled in Pakistan to 5.8% in the Philippines. Rates of complications among women returning for follow-up were low. Expulsion rates were 3.7% in Pakistan, 3.6% in Ethiopia, and 1.7% in Guinea and the Philippines. Infection rates did not exceed 1.3%, and three countries recorded no cases. Offering PPFP/PPIUD at birth improves access to contraception.
authors.affiliation: Jhpiego/MCHIP, Washington, DC, USA. Electronic address: Anne.Pfitzer@jhpiego.org.
authors.forename: Anne
authors.initials: A
authors.lastname: Pfitzer
authors.affiliation: Jhpiego/MCHIP, Washington, DC, USA.
authors.forename: Devon
authors.initials: D
authors.lastname: Mackenzie
authors.affiliation: Jhpiego/MCHIP, Washington, DC, USA.
authors.forename: Holly
authors.initials: H
authors.lastname: Blanchard
authors.affiliation: Jhpiego, Conakry, Guinea.
authors.forename: Yolande
authors.initials: Y
authors.lastname: Hyjazi
authors.affiliation: Jhpiego, New Delhi, India.
authors.forename: Somesh
authors.initials: S
authors.lastname: Kumar
authors.affiliation: Jhpiego, Addis Ababa, Ethiopia.
authors.forename: Serawit
authors.initials: S
authors.lastname: Lisanework Kassa
authors.affiliation: Jhpiego, Manila, Philippines.
authors.forename: Bernabe
authors.initials: B
authors.lastname: Marinduque
authors.affiliation: Jhpiego, Manila, Philippines.
authors.forename: Marie Grace
authors.initials: MG
authors.lastname: Mateo
authors.affiliation: Jhpiego, Kigali, Rwanda.
authors.forename: Beata
authors.initials: B
authors.lastname: Mukarugwiro
authors.affiliation: Ministry of Health, Kigali, Rwanda.
authors.forename: Fidele
authors.initials: F
authors.lastname: Ngabo
authors.affiliation: Jhpiego, Islamabad, Pakistan.
authors.forename: Shabana
authors.initials: S
authors.lastname: Zaeem
authors.affiliation: Jhpiego, Islamabad, Pakistan.
authors.forename: Zonobia
authors.initials: Z
authors.lastname: Zafar
authors.affiliation: Jhpiego, Baltimore, MD, USA.
authors.forename: Jeffrey Michael
authors.initials: JM
authors.lastname: Smith
mesh_terms: D000328:Adult; D005002:Ethiopia; D005193:Family Planning Services / Q000706:statistics & numerical data*; D005260:Female; D016701:Guinea; D006268:Health Facilities / Q000706:statistics & numerical data; D006801:Humans; D007434:Intrauterine Devices / Q000145:classification* / Q000706:statistics & numerical data*; D010154:Pakistan; D010239:Paraguay; D036801:Parturition; D010342:Patient Acceptance of Health Care / Q000208:ethnology*; D010679:Philippines; D049590:Postpartum Period; D012432:Rwanda; D055815:Young Adult
keywords: Intrauterine device; Postpartum care; Postpartum family planning; Prenatal care; Program implementation