Acceptance of birth spacing methods and it’s determinants among postnatal women in a tertiary care setting from Kerala

Background: According to VISION FP2020 healthy birth spacing is defined as delaying the first birth by two years and maintaining the birth interval of at least three years between the two children with the help of various contraceptives.Methods: This was a hospital based cross sectional study conducted among primiparous postnatal women in the department of obstetrics and gynecology SAT hospital, Trivandrum for one year duration. 134 women who had their first delivery were included in this study. A semi structured questionnaire was used to study the sociodemographic variables, reproductive history, contraceptive knowledge, attitude towards contraception and intention to use birth spacing methods by interview technique.Results: The acceptance of birth spacing methods among the study population was 56.8%. 59.1% opted to use family planning methods 6 weeks after delivery while 40.9% planned to use after 6 months. Determinants which were significantly associated with acceptance of family planning methods were education of wife (p<0.01), husbands’ education, socioeconomic status, religion and contraceptive awareness (p<0.01). 47.1% of women preferred DMPA injections, 39.1% opted for intrauterine devices. 13.8% of women opted for condom. Convenience, long term protection, and ease of use were the important reasons cited. The reasons for non-acceptance included fear of side effects, spouse not staying together, opposition from husbands, lack of awareness and religious restrictions.Conclusions: Female literacy, accessibility, cafeteria approach, and counselling contributed to acceptance. If the availability and awareness of injectable contraceptives is made at all the points of health delivery system, the acceptance of birth spacing can further be increased and unplanned pregnancies avoided