Post-placental intrauterine device: expanding access to reproductive health in an African province.

BACKGROUND

Angola has scarce availability of contraceptive methods; the use of post-placental copper intrauterine device (PPIUD) is restricted due to lack of training among professionals and knowledge among women. PPIUD is safe, effective, and scalable solution on contraceptive planning.

OBJECTIVES

To implement PPIUD in two Angolan hospitals, evaluating the access, acceptability of patients and health professionals, and safety of the PPIUD.

METHODS

We performed a prospective study in two Angolan hospitals located in the Province of Cuito, from November 2021 to March 2022, with follow-up durng 45 days after birth. Women were included independently of route of delivery, and excluded if presented anemia, infection, preterm labour, known uterine malformation, fever during labour or rupture of membranes > 24h. Clinical and demographical data was compared between women who retained PPIUD during follow-up.

RESULTS

117 women were invited, and 83 were included (acceptance rate 70.94%),and 81.93% of pregnancies were unplanned. The majority were black (91,6%), had a relationship (59,4%), did not use contraception (63.86%), had 5 or more children (55.42%), and had up to 4 prenatal consultations (70.73%), with an average age of 29.76 (±5.71) years. There were 66.30% vaginal births and 33.70% cesarean sections. Expulsion rate of the PPIUD was 15.66%, most frequently observed after vaginal birth.

CONCLUSION

PPIUD was well accepted and maintained during the first follow-up assessment. The results support the implementation of PPIUD as feasible, representing an important opportunity to prevent unintended pregnancy by achieving women's contraceptive needs.