Integration of family planning with maternal health services: an opportunity to increase postpartum modern contraceptive use in urban Uttar Pradesh, India.

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Abstract

Maternal health (MH) services provide an invaluable opportunity to inform and educate women about family planning (FP). It is expected that this would enable women to choose an appropriate method and initiate contraception early in the postpartum period. In this study we examined interactions with health providers for MH services, and the effect of FP information provision during these interactions on the postpartum use of modern contraceptive methods.

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Most cited references 11

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Effects of birth spacing on maternal health: a systematic review.

A Kafury-Goeta, C A Agudelo, María Bermúdez (2007)

The objective of the study was to explore the association between birth spacing and risk of adverse maternal outcomes. The study was a systematic review of observational studies that examined the relationship between interpregnancy or birth intervals and adverse maternal outcomes. Twenty-two studies met the inclusion criteria. Overall, long interpregnancy intervals, possibly longer than 5 years, are independently associated with an increased risk of preeclampsia. There is emerging evidence that women with long interpregnancy intervals are at increased risk for labor dystocia and that short intervals are associated with increased risks of uterine rupture in women attempting a vaginal birth after previous cesarean delivery and uteroplacental bleeding disorders (placental abruption and placenta previa). Less clear is the association between short intervals and other adverse outcomes such as maternal death and anemia. Long interpregnancy intervals are independently associated with an increased risk of preeclampsia. Both short and long interpregnancy intervals seem to be related to other adverse maternal outcomes, but more research is needed.

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Effect of the interval between pregnancies on perinatal outcomes.

R Rolfs, Barry Nangle, N Horan … (1999)

A short interval between pregnancies has been associated with adverse perinatal outcomes. Whether that association is due to confounding by other risk factors, such as maternal age, socioeconomic status, and reproductive history, is unknown. We evaluated the interpregnancy interval in relation to low birth weight, preterm birth, and small size for gestational age by analyzing data from the birth certificates of 173,205 singleton infants born alive to multiparous mothers in Utah from 1989 to 1996. Infants conceived 18 to 23 months after a previous live birth had the lowest risks of adverse perinatal outcomes; shorter and longer interpregnancy intervals were associated with higher risks. These associations persisted when the data were stratified according to and controlled for 16 biologic, sociodemographic, and behavioral risk factors. As compared with infants conceived 18 to 23 months after a live birth, infants conceived less than 6 months after a live birth had odds ratios of 1.4 (95 percent confidence interval, 1.3 to 1.6) for low birth weight, 1.4 (95 percent confidence interval, 1.3 to 1.5) for preterm birth, and 1.3 (95 percent confidence interval, 1.2 to 1.4) for small size for gestational age; infants conceived 120 months or more after a live birth had odds ratios of 2.0 (95 percent confidence interval, 1.7 to 2.4);1.5 (95 percent confidence interval, 1.3 to 1.7), and 1.8 (95 percent confidence interval, 1.6 to 2.0) for these three adverse outcomes, respectively, when we controlled for all 16 risk factors with logistic regression. The optimal interpregnancy interval for preventing adverse perinatal outcomes is 18 to 23 months.

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Maternal morbidity and mortality associated with interpregnancy interval: cross sectional study.

C A Agudelo, J M Belizán (2000)

To study the impact of interpregnancy interval on maternal morbidity and mortality. Retrospective cross sectional study with data from the Perinatal Information System database of the Latin American Centre for Perinatology and Human Development, Montevideo, Uruguay. Latin America and the Caribbean, 1985-97. 456 889 parous women delivering singleton infants. Crude and adjusted odds ratios of the effects of short and long interpregnancy intervals on maternal death, pre-eclampsia, eclampsia, gestational diabetes mellitus, third trimester bleeding, premature rupture of membranes, postpartum haemorrhage, puerperal endometritis, and anaemia. Short ( 59 months) interpregnancy intervals were observed for 2.8% and 19.5% of women, respectively. After adjustment for major confounding factors, compared with those conceiving at 18 to 23 months after a previous birth, women with interpregnancy intervals of 5 months or less had higher risks for maternal death (odds ratio 2.54; 95% confidence interval 1.22 to 5.38), third trimester bleeding (1.73; 1.42 to 2.24), premature rupture of membranes (1.72; 1.53 to 1.93), puerperal endometritis (1.33; 1.22 to 1.45), and anaemia (1.30; 1.18 to 1.43). Compared with women with interpregnancy intervals of 18 to 23 months, women with interpregnancy intervals longer than 59 months had significantly increased risks of pre-eclampsia (1.83; 1.72 to 1.94) and eclampsia (1.80; 1.38 to 2.32). Interpregnancy intervals less than 6 months and longer than 59 months are associated with an increased risk of adverse maternal outcomes.

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Author and article information

Journal

Journal ID (iso-abbrev): J Fam Plann Reprod Health Care

Title: The journal of family planning and reproductive health care

Publisher: BMJ

ISSN (Electronic): 2045-2098

ISSN (Print): 1471-1893

Publication date (Electronic): Apr 2016

Volume: 42

Issue: 2

Affiliations

[1 ] Senior Technical Specialist, International Center for Research on Women, New Delhi, India.

[2 ] Research Scientist, Harvard Center for Population and Development Studies, Harvard School of Public Health, Cambridge, MA, USA.

[3 ] Technical Specialist, International Center for Research on Women, New Delhi, India.

[4 ] Research Associate, Carolina Population Centre, University of North Carolina, Chapel Hill, NC, USA.

[5 ] Group Director, Social and Economic Development Group, International Center for Research on Women, New Delhi, India.

Article

Publisher Item ID: jfprhc-2015-101271

DOI: 10.1136/jfprhc-2015-101271

PMC ID: 4853573

PubMed ID: 26622056

SO-VID: 5d2ed385-197b-4bc4-80b9-5c1b61fef893

History

Keywords: India,family planning service provision,maternal health services,postpartum contraceptive use,urban

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Keywords: India, family planning service provision, maternal health services, postpartum contraceptive use, urban

Integration of family planning with maternal health services: an opportunity to increase postpartum modern contraceptive use in urban Uttar Pradesh, India.

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Most cited references 11

Effects of birth spacing on maternal health: a systematic review.

Effect of the interval between pregnancies on perinatal outcomes.

Maternal morbidity and mortality associated with interpregnancy interval: cross sectional study.

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