Factors associated with contraceptive use and initiation of coital activity after childbirth

John E Ekabua¹, Kufre J Ekabua², Patience Odusolu¹, Chritopher U Iklaki¹, Thomas U Agan¹, Aniekan J Etokidem^2
1Department of Obstetrics and Gynecology, University of Calabar Teaching Hospital, Calabar, Cross River State, Nigeria; ²Department of Community Medicine, University of Calabar Teaching Hospital, Calabar, Cross River State, Nigeria

Abstract: The aim of the study is to identify the factors influencing contraceptive use and initiation of sexual intercourse after childbirth. This was a cross-sectional descriptive survey involving 256 consecutive women, who delivered between April and October, 2007, presenting at the Immunization Clinic, University of Calabar Teaching Hospital, Nigeria in April, 2008. Data was obtained using an interviewer-administered structured questionnaire. Women who had antenatal and postnatal counseling were significantly more likely to use contraceptives than those who did not have counseling (odds ratio (OR) 0.29; 95% confidence interval (CI) 0.14–0.59; P = 0.0002 and OR 0.18; 95% CI 0.08–0.38; P = 0.0000002 respectively). Other variables significantly associated with contraceptive use included education (P = 0.0470) and reproductive goal (P = 0.0303). Linear regression analysis showed direct relationship between caesarean section and episiotomy as modes of delivery, and initiation of coitus (r² = 0.439 and 0.45 respectively). Concerning residence after childbirth, staying at home and with in-laws showed direct relationship with initiation of coitus (r² = 0.208 and 10.750 respectively). The number of women abstaining from intercourse showed a decreasing trend with increasing months after childbirth. Initiation of coitus was significantly associated with resumption of menstruation (P < 0.0001) and non-contraceptive use (P = 0.0089). In conclusion, this study shows the need for use of postpartum contraception before fecund women become susceptible to pregnancy.

Keywords: postpartum contraception, factors affecting use