EC Gynaecology

Background: Postpartum contraception plays a critical role in promoting maternal and child health by reducing unintended pregnancies and short inter-pregnancy intervals. Immediate postpartum intrauterine contraceptive device (PPIUCD) insertion is recognized as a safe and effective method. Despite its advantages, uptake in India remains low due to a range of socio-cultural, systemic, and provider-related barriers.

Aims: To identify and analyze the barriers to postpartum contraception uptake in India and assess the effectiveness of immediate PPIUCD in improving family planning outcomes.

Methods: A comprehensive literature review was conducted using national surveys, policy reports, and peer-reviewed publications. Sources included NFHS-5 data, Ministry of Health and Family Welfare (MoHFW) reports, RMNCH+A strategy documents, World Health Organization (WHO) guidelines, and implementation studies focused on postpartum contraception.

Results: Despite the high effectiveness of PPIUCD (> 99%), its adoption rate remains below 10% in many Indian states. Major barriers include inadequate awareness, prevalent cultural myths, limited spousal communication, male-dominated decision-making, and gaps in provider training. States like Rajasthan and Andhra Pradesh have demonstrated improved uptake through targeted interventions like antenatal counselling and healthcare provider capacity building.

Conclusion: Improving postpartum contraception uptake, particularly PPIUCD, in India requires multi-level strategies including provider training, strengthened IEC (Information, Education, and Communication) efforts, active ASHA involvement, and integration of counselling into routine antenatal and delivery care services across Primary Health Centre (PHCs), Community Health Centre (CHCs), and district hospitals.

 Keywords: Postpartum Contraception; PPIUCD; Family Planning; Maternal Health; Barriers to Uptake; India; NFHS; ASHA; RMNCH+A Strategy; Immediate IUCD

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