Rate of Acceptance and Complications of Postpartum Intrauterine Con-traceptive Device at Government Maternity Hospital a Prospective Study

Background: Postpartum intrauterine contraceptive device (PPIUCD) insertion provides an effective, reversible, long-acting method of contraception and offers an important opportunity to prevent unintended and closely spaced pregnancies. Despite its advantages, acceptance may be influenced by inadequate awareness, partner preference, sociocultural factors, and fear of complications. Aim: To evaluate the acceptance rate, complications, and continuation pattern of PPIUCD among postpartum women delivering at Government Maternity Hospital, Tirupati, and to identify socio-demographic and clinical factors influencing acceptance and continuation. Materials and Methods: This prospective study included 380 women aged 18–38 years attending Government Maternity Hospital, Tirupati, over a period of one year. Women fulfilling the eligibility criteria were recruited using simple random sampling. PPIUCD insertion using CuT 380A was performed either postplacentally following vaginal delivery or intracaesarean following caesarean section after obtaining informed consent. Participants were followed up at 6 weeks, 3 months, and 6 months, and complications, continuation, and reasons for removal were documented. Results: Of the 380 women studied, 222 (58.4%) accepted PPIUCD, while 158 (41.6%) did not. Safety was the most common reason for acceptance (50.9%), followed by its long-acting nature (18.5%) and non-hormonal benefit (14.0%). Among non-acceptors, partner refusal was the leading reason (57.0%), followed by fear of complications (30.4%). Among acceptors, 205 (92.3%) had no complications, while 17 (7.7%) developed complications. Bleeding was the most common complication (52.9%), followed by pelvic infection (23.5%), fever (17.6%), and expulsion (5.9%). At follow-up, 195 women (87.8%) continued PPIUCD, 11 (5.0%) underwent removal, and follow-up was unavailable for 16 (7.2%). Bleeding/discharge and abdominal pain were the major reasons for removal. Conclusion: PPIUCD was associated with moderate acceptance, a low complication rate, and high continuation among postpartum women. Partner involvement, adequate antenatal counselling, and addressing misconceptions and concerns regarding complications are important to improve acceptance. Appropriate insertion technique, early management of complications, and effective follow-up can further enhance continuation of PPIUCD.