Timing of Insertion and Complications Within Six Weeks of Postpartum Intrauterine Contraceptive Device Use Among Youths in Thika Level V Hospital.

Abstract

Background: Globally the adolescent birth rate was 44 births per 1,000 in 2018, compared to 56 births per 1000 in 2000. In Kenya, the adolescent birth rate is 96 per 1,000 women. In the last five years, the teenage pregnancy rate has remained unchanged at 18%, while the unmet need for family planning services for youth is averaged at 23% (KDHS, 2014). A majority of adolescent pregnancies in Kenya are unintended and unwanted. These pregnancies are preventable with contraception such as LARC like IUDs. In Kenya, there is little data on the use of IUD in adolescence with a few suggesting extreme low usage. Study Objectives: To determine the type of insertion and complication within six weeks of postpartum IUCD use amongst youth in Thika County. Methodology: The study was a cross-sectional study, utilizing secondary data from Thika level 5 hospital that was collected from the project, institutionalization of immediate postpartum IUD in six Counties in Kenya conducted by KOGS and FIGO.Data were conveyed to the Statistical Package for the Social Science(SPSS 23) software, cleaned, confirmation of study variables, coding and analysis done. Descriptive statistics for the sociodemographic characteristics of participants were analyzed and presented in the form of proportions and means. Uptake of postpartum intrauterine devices was expressed as a prevalence. RESULTS: Majority who has PPIUCD inserted was in the age group of 19-22 years (48%) followed by 23-24 years (40%). On marital status, 195 (75%) were married. Most of the youth were housewives (48 %) while 54 (21%) were students. Primipara mothers accepted PPIUCD more at 146 (56%). Close to 62% of youth had never used family planning before, with 38% having a prior history of family planning use. Majority of the youth, 228 (88%) had no complications immediately after insertion while the main complaint was severe pain in 20 (8%) and heavy bleeding in 12(5%) of the youth. No perforation was reported after insertion. IUCD insertion done intra-operatively at cesarean section were 152 (59%) while 106 (41%) of youth had insertion done between 10 minutes to 48 hours post vaginal delivery. The majority of the youth came back for follow-up 238 (92%) at 6 weeks. Out of the 238 who came for follow -up, 38 (39%) complained of complications such as irregular bleeding while only 5% had spontaneous IUCD expulsion at 6 weeks. CONCLUSION: PPIUCD is acceptable to youth and is a safe convenient method with minimal adverse effects in both vaginal and cesarean deliveries.