Continuity of care and socio-demographic predictors of postpartum family planning utilization among women with a high-risk pregnancy in Indonesia: case-control study

Introduction: Postpartum Family Planning (PPFP) coverage in Indonesia has reached only 23%, which has an impact on the risk of an unwanted pregnancy. Pregnant women with too young, too old, and too many children are one of the factors that cause high maternal and infant mortality rates. This study aims to analyze factors influencing PPFP in mothers with high-risk pregnancies.

Methods: A case-control study of 496 respondents in 66 health centres in Banyumas and Cilacap, Central Java, was selected through random cluster sampling using a researcher-made questionnaire. This research was conducted in 2022.

Results: Factors that influence the use of PPFP are continuity of care (aOR 4.83; 95%CI 1.52-6.81; p=0.001), medical history during pregnancy and childbirth (aOR 3.31; 95%CI 1.39-5.48; p=0.021), parity (aOR 3.49; 95%CI 0.94-13.04; p=0.030), prior contraception (aOR 6.88; 95%CI 3.92-11.91; p=0.001), Information Education and Communication (aOR 17.72; 95%CI 10.73-20.15; p=0.001), husband support (aOR 8.92; 95%CI 5.1-15.92; p=0.001), health service satisfaction (aOR 4.21; 95%CI 1.26-5.78; p=0.001). In contrast, several factors like the mother's age, mother's educational status, and lactational amenorrhea method do not influence the use of PPFP.

Conclusion: A history of high-risk pregnancies, births, and postpartum heavily influences PPFP. It has been demonstrated that PPFP considerations can lower maternal and newborn mortality rates. Programs to increase the coverage of PPFP participation need to consider various factors, both internal to the mother and external to program readiness.