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 Table of Contents  
ORIGINAL ARTICLE
Year : 2021  |  Volume : 8  |  Issue : 2  |  Page : 136-140

A correlation study to assess the knowledge and attitude regarding postpartum intrauterine contraceptive device (PPIUCD) among women admitted in antenatal and postnatal wards: An institutional study


State College of Nursing, 107, Chander Nagar, Ajabpur Kalan, Dehradun 248001, Uttarakhand, India

Date of Submission27-Jan-2021
Date of Acceptance16-Feb-2021
Date of Web Publication02-Jun-2021

Correspondence Address:
Ms. Deepika Ghildiyal
State College of Nursing, 107, Chander Nagar, Ajabpur Kalan, Dehradun 248001, Uttarakhand.
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/mgmj.mgmj_5_21

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  Abstract 

Introduction: India is the second most populous country in the world. Intrauterine contraceptive device (IUCD) is a very effective, reversible, and economical family planning method. In India, the acceptance rate of IUCD is very low, only 3% of the women in the reproductive age group are using IUCD. Aims: The study was conducted to assess the knowledge and attitude regarding the postpartum intrauterine contraceptive device (PPIUCD) among women. Materials and Methods: A descriptive approach with a non-experimental research design was used for the study. The subjects were 180 women selected by the non-probability convenience sampling technique. The study was conducted among the women admitted in antenatal and postnatal wards at Doon Medical College Female Hospital, Dehradun, Uttarakhand. Results: The study showed that 54.44% (98) of the women have average knowledge about PPIUCD, 21.11% (38) have poor knowledge, 23.33% (42) did not know, and only 1.11% (2) was having good knowledge about it. The study revealed that favorable and unfavorable attitudes toward PPIUCD of women were 43.33% and 56.67%, respectively. The present study communicated that there was no correlation (−0.113) between knowledge and attitude toward PPIUCD among women. The finding suggested that women had average knowledge and unfavorable attitude toward the PPIUCDs. The χ2 value showed that demographic variables such as age, family income, and education status were having an association with the level of knowledge regarding the PPIUCD. No association was found between attitude and selected demographic variables. Conclusion: Findings stress the need for teaching programs, which in turn may enhance the knowledge and attitude of women regarding the PPIUCD. It will also helpful in improving the health status of women. It may reduce maternal morbidity and mortality.

Keywords: Attitude, contraceptive device, intrauterine, knowledge, postpartum, women


How to cite this article:
Ghildiyal D. A correlation study to assess the knowledge and attitude regarding postpartum intrauterine contraceptive device (PPIUCD) among women admitted in antenatal and postnatal wards: An institutional study. MGM J Med Sci 2021;8:136-40

How to cite this URL:
Ghildiyal D. A correlation study to assess the knowledge and attitude regarding postpartum intrauterine contraceptive device (PPIUCD) among women admitted in antenatal and postnatal wards: An institutional study. MGM J Med Sci [serial online] 2021 [cited 2021 Sep 20];8:136-40. Available from: http://www.mgmjms.com/text.asp?2021/8/2/136/317450




  Introduction Top


Postpartum intrauterine contraceptive devices (PPIUCDs) are postpartum family planning methods, which can be provided to a postpartum woman within the first 48 h of the postpartum period. In most developing countries, delivery time is the key time for women to access postpartum family planning methods, especially for those living in rural and remote areas.[1] Reproductive and child health care is an integrated and composite approach for safe motherhood which leads to a healthy pregnancy and safe delivery. So, education regarding all aspects of safe reproductive child health is essential for mothers and will enable them to adopt a positive attitude regarding the reduction of infant mortality rate and maternal mortality rate.[2]

Population explosion is the most important problem in India. Almost 48.1 million pregnancies in India were unintended. In India, 65% of the women within the first year after delivery have an unmet need for family planning. PPIUCD is a long-term reversible, safe, feasible, and cost-effective method of contraception that avoids unwanted pregnancies. Spacing between pregnancies reduces abortion rate, preterm births, low birth weight babies, intrauterine deaths, and postpartum hemorrhage, which can reduce the maternal morbidity and mortality and infant mortality rate.[3] Every year about 200 million infants of low birth are born worldwide which impose a heavy burden on healthcare and social system in developing countries.[4] PPIUCD is associated with less discomfort and fewer side effects (bleeding, relief of overcrowded outpatient facilities, protection against unwanted pregnancy, and consequent abortion).[5] It is safe for use by HIV-positive women on antiretroviral therapy.

Apart from the above, it does not interfere with breastfeeding. PPIUCD has proven advantage over interval IUCD or other family planning methods. There is no pain or low risk for rejection in the mother, and the insertion procedure is easily performed after delivery. Therefore, this reduced perception of initial side effects (bleeding and cramping) due to the presence of normal puerperal changes, has no risk of uterine perforation because of the thick wall of the uterus, is convenient, and saves time and additional visits. The recommended interval before attempting the next pregnancy is at least 24 months to reduce the risk of adverse maternal, perinatal, and infant outcomes; thus by limiting births, preventing closely spaced births, or births to very young or old mother, neonatal, and infant, child and maternal mortality can be reduced. PPIUCDs are still emerging as a relatively new contraception choice in India. While follow-up data on complications with PPIUCD insertions were available from international sources, studies from India are limited. Additionally, information related to the demographic profile of women who accept PPIUCDs, the dynamics of their decision-making process, and their mindset about this method of contraception have not been well characterized. Women and couples are highly motivated and more receptive to family planning methods during the postpartum period. This period is defined as a period of 6 weeks after delivery. There are chances of unwanted pregnancies due to delayed initiation of contraception selection and practices by couples during the postpartum period. Adequate intervals between pregnancy and spacing are important for the health of mother and child.[6] Therefore, we conducted a prospective, observational study of the recent trends of women toward PPIUCD use. Delay in the use of contraception by couples during the postpartum period can result in many unwanted/unintended or mistimed pregnancies.[7]


  Materials and methods Top


The present study was conducted to find out the correlation between knowledge and attitude regarding the PPIUCD among women admitted in antenatal and postnatal wards at Doon Medical College Female Hospital, Dehradun, Uttarakhand, India. The research approach selected for the study was the quantitative research approach. For the study, a non-experimental descriptive research design was used. The study was conducted among 180 women admitted in antenatal and postnatal wards of the selected hospitals. The subjects were selected for the study by non-probability convenience sampling method. The conceptual framework provides a perspective regarding interrelated phenomena, and the model used in this study is based on Rosenstock’s and Becker’s health belief model.

Data collection was done by using socio-demographic data tools, self-structured knowledge questionnaires, and attitude scales. The knowledge score range was 0–20 and the attitude scale range was 0–48. The level of knowledge was divided into four categories: no knowledge (<25%), poor knowledge (25–40%), average knowledge (40–70%), and good knowledge (>70%). The level of attitude was interpreted as unfavorable (<56%) and favorable (56–100%). Prior permission was obtained from the Ethical Committee and administrative authorities of the State College of Nursing. Informed written consent was taken from respondents, and confidentiality was maintained throughout the study. Duration of data collection was 2 weeks, and each participant took 25 min to fill the questionnaires.


  Results Top


In the present study, distribution of women according to their age shows that most of the women, 8 (47.2%), were in the age group of 20–25 years and only eight (4.4%) of the participants were found in the age group of 36–40 years. Most of the samples were Hindus 133 (73.8%), and Sikhs were only 3 (1.7%). Most of the participants were housewives 145 (80.6%), and the remaining nine (5.0%) were government employees. Regarding family, most of the participants were having, 115 (63.9%), joint family and 65 (36.1%) were having nuclear family. The study communicated that among 180 women only 137 women had knowledge about PPIUCD, and among 137 women, only 38 (27.73%) women had poor knowledge, 97 (70.80%) women had average knowledge, and the remaining 2 (1.45%) women had good knowledge about PPIUCD [Table 1].
Table 1: Frequency and percentage distribution of socio-demographic characteristics of women (N = 180)

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Karl Pearson’s correlation (r) between knowledge and attitude was −0.113 and significant at P < 0.05 level. The value indicates that there was a weak correlation (no correlation) between knowledge and attitude. The findings of the present study concluded that there was a statistical association between selected demographic variables and knowledge of women regarding the PPIUCD. The finding showed that there was a significant association among knowledge, age of woman, family income, educational status of woman, previous knowledge regarding the PPIUCD, and source of information. Hence, it can interpret statistically that the age of woman, monthly family income, educational status of woman, previous knowledge about PPIUCD, and source of information are associated with the level of knowledge of women regarding the PPIUCD. The findings of the present study concluded that there was no statistical association between selected demographic variables and attitude of women regarding the PPIUCD.


  Discussion Top


Family planning is very important for population control. There are various methods of family planning in males and females. PPIUCD is a convenient and cost-effective method of family planning. Data communicated that 47.2% of the women were between 20 and 25 years. Nearly three-quarters of the subjects were Hindus, and mostly women (80.6%) were housewives. The present study revealed that 23.33% of the women have no knowledge, 21.11% have poor knowledge, and 54.44% of the women have a good knowledge regarding PPIUCD. Yadav and Koshalya conducted a descriptive study to assess knowledge and attitude regarding PPIUCDs among antenatal mothers at Mahila Chikitsalaya, Sanganeri Gate, Jaipur. A sample of 70 antenatal mothers was chosen by systematic sampling technique. The majority (81.4%) of antenatal mothers had poor knowledge regarding the PPIUCD. The present study communicated that 44.44% of the women had no knowledge and poor knowledge; it was supported by the study. The study was supported by the findings of the study conducted by Monji and Naidoo[7] to evaluate knowledge and attitude toward the IUCD among women attending antenatal and postnatal clinics at Northdale Hospital (NDH) in Pietermaritzburg, South Africa.[8]

Our study was supported by the study conducted by Khawaja et al.[8] The study revealed that 55% of the women know about IUDs. In our study, 54.44% of the women have average knowledge about PPIUCD. This is in agreement with the study by Valliappan et al.[9] wherein 44.8% of the women have some knowledge regarding PPIUCD. In the study by Gadade et al. also, the majority (58%) of the study population have average knowledge of PPIUCD. Thus, the knowledge of our study population is similar to that of the study by Gadade et al.[10] In terms of attitude, only 43.33% of the women have a favorable attitude toward PPIUCD, and the remaining 56.67% of the women have an unfavorable attitude toward PPIUCD [Table 2]. The present study finding is supported by the study findings of Yadav and Koshalya who reported that 50% of the women have a favorable attitude toward PPIUCD.[7] Regarding attitude toward PPIUCD, Sunanda and Sudha[11] communicated that 51.75% of the women have a positive attitude toward PPIUCD and it is supporting the present study. We observed that there was no statistical association between knowledge and attitude of women regarding the PPIUCD [Table 3]. There was no study to support the present findings. The present study also communicated that there was no statistical association between selected demographic variables and attitude of women regarding PPIUCD [Table 4]. Our findings revealed that there is a need to increase the knowledge and favorable attitude of women toward PPIUCD.
Table 2: Distribution according to the level of knowledge and attitude (N = 180)

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Table 3: Correlation between knowledge and attitude of women regarding the PPIUCD (N = 180)

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Table 4: Association among knowledge, attitude, and socio-demographic characteristics of women (N = 180)

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  Conclusion Top


Maternal and child health are important indicators of health. Effective family planning is necessary for population control and woman health. Knowledge and attitude regarding PPIUCDs are necessary among women. The present study discussed that women have average knowledge and unfavorable attitude regarding PPIUCD. There is a need to develop and implement an educational program to enhance the knowledge and attitude of women toward PPIUCD.

Limitations

The study was limited to the women admitted in antenatal and postnatal wards only. Samples were only selected according to the convenient sampling technique. Data collection was done only for the short period.

Recommendations

A similar study can be done on a large group of community for long period.

A study can be done to find out the prevalence of PPIUCD.

A similar study can be done to know the knowledge and attitude of the rural community regarding PPIUCD.

Acknowledgements

Researchers would like to acknowledge the Ethical Committee, Principal State College of Nursing, and all the participants for their support in the study.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Abebaw Y, Berhe S, Abebe SM, Adefris M, Gebeyehu A, Gure T, et al. Providers’ knowledge on postpartum intrauterine contraceptive device (PPIUCD) service provision in Amhara region public health facility, Ethiopia. PLoS One 2009;14:e0214334. doi: 10.1371/journal.pone.0214334  Back to cited text no. 1
    
2.
Dutta DC Textbook of Obstetrics. 6th ed. New Delhi: New Central Book Agency; 2004.  Back to cited text no. 2
    
3.
Pradeep MR, Nayana DH Study of knowledge, attitude, and acceptance of PPIUCD in antenatal mothers. New Indian J OBGYN 2019;6:42-4.  Back to cited text no. 3
    
4.
Suchitra A, Jawadagi S, Pujari, J. A study to assess the factors affecting the acceptance of intrauterine device (IUD) among rural women of Hirebagewadi Sub-Center Belgaum. ISOR J Nurs Health Sci 2014;3:37-52.  Back to cited text no. 4
    
5.
Latha P Effectiveness of a structured teaching program on newborn care among primi mothers at Govt. Hospital, Bhadrachalam, Telangana. Narayana Nrs J 2015;4:24-7.  Back to cited text no. 5
    
6.
Yadav A, Koshalya, . Knowledge and attitude among antenatal mothers regarding PPIUCD at a selected hospital of Jaipur district. Int J Med Health Res 2017;3:63-5.  Back to cited text no. 6
    
7.
Monji, BP, Naidoo TD Attitude towards and knowledge about intrauterine contraceptive devices. South Afr J Obst Gyn 2015;21:27-32.  Back to cited text no. 7
    
8.
Khawaja NP, Tayyeb R, Malik N Awareness and practices of contraception among Pakistani women attending a tertiary care hospital. J Obstet Gynaecol 2004;24:564-7.  Back to cited text no. 8
    
9.
Valliappan A, Dorairajan G, Chinnakali P Postpartum intrauterine contraceptive device: Knowledge and factors affecting acceptance among pregnant/parturient women attending a large tertiary health center in Puducherry, India. Int J Adv Med Health Res 2017;4:69-74.  Back to cited text no. 9
    
10.
Gadade M, Sajan AC, Ansari J, Bhavi R, Jolly AM, Choubsia B A study to assess the knowledge regarding the post-partum intrauterine contraceptive device (PPIUCD) among post-natal mothers in selected hospitals of Pune city. Pharma Inno J 2019;8:200-2.  Back to cited text no. 10
    
11.
Sunanda KM, Sudha HC PPIUCD, a success store at VVH: A retrospective study. J Evid Based Med Healthc 2015;2015: 6820-5.  Back to cited text no. 11
    



 
 
    Tables

  [Table 1], [Table 2], [Table 3], [Table 4]



 

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