Role of Male Partners in Postpartum Family Planning

Abstract

Background: Strategies to increase the uptake of contraception services have been adopted in Rwanda but the unmet needs for family planning remains high. Women in postpartum period are at higher risk for unintended pregnancy due to the silent conversion from lactational amenorrhea to reactivation of ovulatory cycles. The purpose of this study was to explore the role of male partners on the uptake of postpartum contraception. Methods: A prospective cross-sectional study was conducted among women who delivered at the University Teaching Hospital of Kigali during a period of 3 months with random sampling. A questionnaire was used to collect socio-demographic and antenatal data, information on male companionship, and intent to use postpartum contraception at admission. Participants were contacted 6 weeks later to collect data on contraceptive use. The outcome variables were uptake of postpartum contraception and types of contraceptive taken (long acting vs short acting) controlling for male companionship during antenatal period. Chi-square test was used and p-value ≤0.05 was considered significant. Results: A total of 209 women were recruited with mean age of 30.8±5.2 years. The majority (60.9%) were multigravida, 66.5% were multiparous. More than half (55%) had male partner companionship, 18.3% had companionship for 4 antenatal visits, 28.2% had education on contraception with their male partner. Factors significantly associated with uptake of postpartum contraception were: age above 30 years, owning or heading a business, multigravidity, multiparity, antenatal care at health center or district hospital, caesarean delivery, and previous utilization of contraception. Male companionship significantly increased the intent to use contraception, uptake of modern contraception in general, and uptake of long active contraceptives but did not predict the uptake of short acting contraceptives. Conclusions: Our study demonstrates positive association between male companionship during antenatal care, labor and delivery with uptake of postpartum family planning. Our study suggest, more sensitization to involve the male partners, improve the education on contraception during antenatal care and further research to assess the sustained uptake of contraception beyond the postpartum period