Acceptance Barriers to Newer Postpartum Contraceptives in the Early Postpartum Period: A Cross-sectional Study from Western UP, India

Background:The most important period to initiate contraception is the early postpartum period, which needs urgent addressing to scale up newer postpartum contraceptive uptake.Materials and methods: It was a cross-sectional, questionnaire-based study including 156 women in the early postpartum period eligible for contraception but refused newer postpartum contraceptives.We divided the data into two groups depending on previous contraceptive usage: Group I-62 (39.7%) women who had used contraception previously. Group II-94 (60.3%) women who had never used contraception.Results: Only 33.9% women from group I had used an effective modern contraceptive.Only 42.9% of study participants were aware of one or more of the newer postpartum contraceptives, with medical staff and media playing a limited role in spreading awareness.Mother-in-law and husband were reported as the main decision-makers in both groups by 133 (85.25%) participants who stated their inability to decide independently regarding modern contraceptive usage.There was a significant difference between the two groups with respect to a few myths that were more prevalent in group I-no need for modern contraceptives till lactational amenorrhea, and in the first year postpartum (p = 0.008 and p = 0.03, respectively).Concerns related to time since delivery (72.43%), mode of delivery (23.08%), and accessibility (26.28%) were raised mainly from group II.Parity and religious concern were found to be independently associated with newer postpartum contraceptive usage. Conclusion:The evidence generated suggests that tailored joint-counseling involving husband and mother-in-law, public awareness programs, and ensuring full-range contraceptive accessibility are urgently warranted to meet the unmet need for newer contraceptives in the early postpartum period in UP.Clinical significance: Interventional studies can be planned to examine the impact of tailored counseling in removing the barriers identified.