Immediate Postpartum Copper IUD: A Comparative Analysis between Profiles of Women who Accept and who Refuse it

Abstract

Objective To analyze the profiles of women who accepted and who refused the insertion of the copper intrauterine device (IUD) postpartum and to learn the motivations related to the refusal of the method.

Methods Cross-sectional study with 299 pregnant women. The women were informed about the possibility of inserting a copper IUD postpartum and were questioned about their interest in adopting or not this contraceptive. All participants answered a questionnaire with information relevant to the proposals of the present study. The sample size was limited to the number of devices available for the present study.

Results A total of 560 women were invited to join the present study and 299 accepted. Out of the 299 women included in the present study, 175 accepted the copper IUD and 124 refused. As the number of pregnancies increased, the IUD acceptance rate raised (p = 0.002), especially between the groups with 1 and with ≥ 4 pregnancies (p = 0.013). Regarding the desire to have more children, the women who planned to have more children were more likely to refuse the method than the ones who did not (p < 0,001).

Conclusion Women with multiple pregnancies and desire to not have more children were more likely to accept the copper IUD. The profile of those who refused was first pregnancy and desire to have more children. Among the three most frequent reasons reported for copper IUD rejection, two responses stood out: no specific justification and desire to have more children.

Resumo

Objetivo Analisar o perfil das mulheres que aceitaram e recusaram a inserção do dispositivo intrauterino (DIU) de cobre no pós-parto imediato e conhecer as motivações relacionadas à recusa ao método.

Métodos Estudo transversal com 299 gestantes, as quais foram informadas sobre a possibilidade de inserir o DIU de cobre imediatamente após o parto e questionadas sobre o interesse em adotar ou não este contraceptivo. Todas as participantes responderam a um questionário com informações pertinentes às propostas do presente estudo. O tamanho da amostra foi limitado ao número de dispositivos disponíveis para o presente estudo.

Resultados Um total de 560 mulheres foram convidadas a participar do estudo, dentre as quais 299 aceitaram. Das 299 participantes, 175 aceitaram o DIU e 124 recusaram. Conforme aumentou o número de gestações, maior foi a taxa de aceitação do DIU (p = 0,002), principalmente quando comparados os grupos de mulheres com 1 e ≥ 4 gestações (p = 0,013). Quanto ao desejo de ter mais filhos, as mulheres que planejavam ter mais filhos tiveram maior chance de recusar o dispositivo do que as que não planejavam (p < 0,001).

Conclusão Mulheres com múltiplas gestações e sem desejo de ter mais filhos apresentaram maior probabilidade de aceitar o DIU. O perfil das que recusaram foi primeira gravidez e desejo de ter mais filhos. Dentre os três motivos mais frequentes de rejeição do DIU relatados, duas respostas se destacaram: a falta de justificativa específica e o desejo de ter mais filhos.

Keywords

intrauterine devices - contraception - postpartum period - family planning services - copper intrauterine device

Palavras-chave

dispositivos intrauterinos - anticoncepção - período pós-parto - planejamento familiar - dispositivo intrauterino de cobre

Contributions

All authors contributed to the design of the present study, were involved in the data collection, data analysis and/or interpretation. Also, all authors contributed to the writing/substantive editing and review of the manuscript and approved the final draft of the manuscript.

Publication History

Received: 13 October 2020

Accepted: 05 October 2021

Article published online:
25 February 2022

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