Women’s decision versus couples’ decision on using postpartum intra-uterine contraceptives

BACKGROUND: In conservative societies of low- and middle-income countries, the decision-making process is heavily influenced by male partners. AIMS: To assess the male partner's influence on female partner's ultimate decision regarding uptake of postpartum intrauterine contraceptive device (PPIUCD). METHODS: This was a prospective, analytical study conducted at Abbasi Shaheed Hospital, Karachi, Pakistan, from 1 March 2016 to 30 August 2016. The study included 566 pregnant women who were counselled regarding postpartum contraception (PPC) and asked to choose their preferred method. The choice was noted before and after discussion with their spouse. Discordance was assessed using McNemar's test for paired samples, taking P ≤ 0.05 as statistically significant. RESULTS: Among those counselled, 470 (83.03%) showed willingness to accept PPC. Out of these, 142 (30.2%) chose PPIUCD initially. After discussion with their spouse, only 82 (17.4%) accepted PPIUCD. The discordance between original decision of the woman and final decision to accept PPIUCD was statistically significant (P < 0.001). CONCLUSIONS: The discordance between original decision and final decision shows considerable influence by males on uptake of PPIUCD.