The Use of Immediate Postpartum Family Planning at Kacyiru Hospital, Rwanda

INTRODUCTION: Immediate PostPartum Family Planning (PPFP) is the initiation of Family Planning (FP) methods within 48 hours after delivery. Its uptake remains low in sub-Saharan Africa, including Rwanda. This study aimed at analyzing use and identifying motivators and barriers leading to immediate PPFP acceptance among Rwandan women at Kacyiru Hospital (KH), Kigali, Rwanda.
METHODS: This was a qualitative study conducted on postpartum mothers from 1st September to 31st October 2018. The participants were selected by purposive and convenience sampling with respected ethical considerations. In-depth interviews were used to identify themes.
RESULTS: A total of 28 women were enrolled for in-depth 45-minute interviews. Among them, 19 participants accepted and nine refused immediate PPFP. Motivators identified were: Socio-economic reasons, awareness of complications to closely spaced pregnancies, time to breastfeed, peer motivation, prevention of multiple hospital visits, cesarean delivery, freedom to unprotected sex, avoidance of family conflicts, being responsible, confidence in stopping contraception at any time and old age. Barriers were: Perceived poor efficacy and side effects of contraceptive methods, belief of inability of getting pregnant after delivery before resuming menses, religious belief, husband/partner’s opinion, fresh cesarean wound, peer demotivation, and first pregnancy.
CONCLUSION: Immediate PPFP uptake is affected with intrinsic and extrinsic factors. Partners and the community (peers) play a role in process of making decision among women who deliver at Kacyiru hospital. Accelerating male participation and engaging with the wider community through innovative strategies that compete with misinformation would improve partnerships with religious leaders.