Women’s Perspectives and Experiences Using Postpartum Intrauterine Device in Tanzania

Sarah Huber-Krum, Harvard University
Leigh G. Senderowicz , Harvard University
Kristy Hackett, Harvard University
Erin Pearson, Ipas
Iqbal H. Shah, World Health Organization (WHO)
Helen Siril, Management and Development for Health, Dar es Salaam, Tanzania

Despite numerous benefits of the immediate postpartum copper intrauterine device (PPIUD), it is underutilized in many resource-constrained settings, including Tanzania. We conducted in-depth interviews with 20 pregnant women who received contraceptive counseling during routine antenatal care in 2016-17 and 27 postpartum women who had PPIUD inserted in 2018 to understand reasons for use versus non-use and continuation versus discontinuation. Primary motivators to use PPIUD included: perceived lack of side-effects, convenience, effectiveness, and duration of pregnancy protection. Barriers to use included: fear of insertion, concerns related to sexual experiences post-insertion, and limited knowledge. Women who had PPIUD inserted continued use when their expectations matched their experience, while discontinuation resulted from unexpected expulsion and experience of unanticipated side-effects. Frequent follow-up and guidance on side-effect management influenced women’s decisions to continue use. To support uptake and continued utilization of PPIUD, postpartum contraceptive counseling should explicitly address side-effects and risk of expulsion.

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 Presented in Session 10. Fertility, Family Planning, Sexual Behavior & Reproductive Health 2