Antenatal Contraceptive Counselling and Postpartum IUD Use: Evaluation of Contraceptive Service in Tertiary Hospital in Indonesia

Background: Effective contraceptive use is one of a measure of decreasing maternal mortality rate. The low contraceptive prevalence rate of the IUD as a LARC is partly caused by a lack of knowledge regarding the method. Antenatal contraceptive counselling is considered a potential factor in increasing the use of postpartum IUD. Though it has been a part of routine service, the effectiveness of antenatal contraceptive counselling in our center was seldom studied.
Methods: Seventy women who underwent antenatal care in the third trimester in our center were enrolled in the study. Contraceptive counselling was given integrated with antenatal care visits. A questionnaire for measuring knowledge, attitude, and contraceptive choice was given before and after contraceptive counselling. Postpartum contraceptive method usage was evaluated after birth.
Results: Fifty eight women were enrolled and included in the final analysis. Before counselling, only 39.7 percent of subjects had a good level of knowledge, and 36.2 percent subjects had a good level of attitude. While after counselling 75.9 percent of subjects had a good level of knowledge and 72.4 percent subjects had a good level of attitude. Before counselling, IUD uptake was only 15.5 percent, while post-counselling, 77.6 percent of subjects chose and used IUD as their post-partum contraceptive method.