The possibilities of improvement of post-partum contraception

Abstract

Objective: Our purpose was to improve the system of post-partum contraception in agricultural regions.

Full Text

Methods: Individual work on choice of a post-partum contraceptive method had been conducted during the pregnancy and after delivery among 250 women, residents of typical agricultural region of Central Russia.

Results: After delivery 7,5% of patients used surgical sterilization, 20,8% - intrauterine devices (IUD); 2,5% - hormone contraceptives, 54% - other contraceptive methods and 9,2% of parturient reject any contraceptives.

Surgical sterilization was carried out on 1-4 days after vaginal delivery via mini laparotomy under intravenous anesthesia without any immediate and remote complications. Insertion of IUD’s was performed on 5-7 days after delivery in absence of clinical, bacteriological, ultrasound and histological (in placenta) features of inflammatory pelvic diseases. Medical complications during I year after inserting IUD were registered in 3,6% of cases (2,4%) - inflammatory pelvic processes; 1,2% - menometrorrhagia. Progestogens (pills and injectables) were used as hormone contraceptives. Patients begun it’s use in 1 month after delivery. The related medical complications were metrorrhagia with the rate 2,9%. Developed system of post-partum contraception resulted in 4,5% reducing of frequency of unplanned pregnancy during the 1^st year after delivery.

Conclusion: The developed system of post-partum contraception permits to reduce the frequency of unplanned pregnancy during the 1^st year after delivery. However, the significant quantity of women, residents of agricultural regions are not ready yet to use modern contraceptive technologies (especially sterilization and hormones) in post-partum period and adopted other contraceptive measures or use no contraception at all, what led to high level of artificial abortions.