Authors
Gowri Anil Peethambara, Anjalidevib
aMBBS student, Government Medical College, Trivandrum;
bDepartment of Obstetrics and Gynecology, Government Medical College (SAT Hospital), Trivandrum.
Abstract
Context: A cross sectional study was conducted among willing mothers coming to Immunization clinic in SAT Hospital, Trivandrum, who had not undergone permanent sterilization.
Objective: To assess the knowledge, attitude and practice of these mothers towards spacing. The secondary objectives were to explore factors influencing their decision and also to assess the service of JPHN in providing them with prenatal counselling.
Materials and Methods: Non probability sampling done to select 100 samples between January 2017 to March 2017. Questionnaire in Malayalam was administered by the interviewer. Data analysis was done using SPSS software. Descriptive procedures like percentages and analytical procedures like Chi-square ratios were done.
Results: The mean age of women was 26.74 years. There were 6 cases where age of marriage was less than 18 years. 79% of women and 52% of their husbands had education past high school. 51% of the women were below poverty line and 61% were primi-paras. 71% were housewives and 40% of the husbands were skilled workers.
70% of women were aware of at least one modern spacing method, though only 52% of them were sure of its correct use. Level of knowledge was maximum regarding intrauterine devices (Cu-T).
Though 87% felt the need for spacing of 3-5 years between pregnancies, only 12% were willing to adopt any modern spacing method. In 57.5% of cases, the decision was taken by the woman herself. The most common reason for not using spacing methods was fear of side effects (50.6%). 21.8% faced hindrance from husband and relatives.
The most commonly used spacing method was intrauterine devices (72.7%). Nine women said they would want to terminate an unplanned pregnancy in the future.
Only 7% had received antenatal counseling about spacing from health professionals. Out of 95 women who were registered with their PHC, 29.5% were visited by the JPHN less than 3 times during their pregnancy period. On Chi- square analysis, statistically significant relationship was found between awareness and socioeconomic status (P = 0.003), awareness and parity (P = 0.009), knowledge and education of women (P = 0.040), use and occupation of women (P = 0.041), knowledge and use (P = 0.000).
Conclusion: The study stresses the huge knowledge- attitude-use gap among women and the unmet need for spacing. Even among highly educated women, myths regarding side effects of contraceptives still do exist. Proper prenatal counseling is the key to overcome this huge gap.
Keywords: Spacing of Pregnancies, Factors Influencing Spacing of Pregnancies, Service of JPHN for Prenatal Counselling