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Contraceptive practice after surgical repair of obstetric fistula in southeast Nigeria
Author(s) -
Lawani Lucky O.,
Iyoke Chukwuemeka A.,
Ezeonu Paul O.
Publication year - 2015
Publication title -
international journal of gynecology and obstetrics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.895
H-Index - 97
eISSN - 1879-3479
pISSN - 0020-7292
DOI - 10.1016/j.ijgo.2014.11.028
Subject(s) - medicine , socioeconomic status , obstetrics , condom , pregnancy , fistula , family planning , birth control , gynecology , cohort study , population , family medicine , surgery , human immunodeficiency virus (hiv) , environmental health , research methodology , syphilis , biology , genetics , pathology
Objective To determine the contraceptive practices of women after surgical repair of obstetric fistula and to assess determinants of uptake and the pregnancy rate in the first year. Methods A prospective cohort study enrolled women who had a successful surgical repair of obstetric fistula at a center in Nigeria between 2011 and 2013. Patients were followed up for 1 year. Data were obtained through record review and completion of a semi‐structured questionnaire. Results Among 188 participants, 180 (95.7%) were aware of contraception, but only 70 (37.2%) used contraceptive methods after surgery. The most commonly used methods were the male condom (50 [71.4%] of 70) and hormonal injections (14 [20.0%]). The main reasons for non‐use were fear of adverse effects (48 [40.7%] of 118 women), future desire for more children (35 [29.7%]), religious prohibition (26 [22.0%]), cultural beliefs (29 [24.6%]), and partner disapproval (42 [35.6%]). The risk of unplanned pregnancy in the first year was significantly lower among women who used contraceptives than among those who did not (relative risk 0.14, 95% confidence interval 0.02–1.06; P = 0.03). Conclusion Contraceptive uptake for birth control after fistula repair surgery was low because of socioeconomic reasons, religious and cultural beliefs, and myths, resulting in unplanned pregnancies.