By: Sara Pellegrom, Women Deliver
A new initiative, led by Jhpiego and funded by the David and Lucile Packard Foundation, is providing counseling to women about postpartum family planning methods to prevent unwanted pregnancies and space births to improve the health of the mother and child.
The program has trained 425 maternal health care providers of different skill levels across 21 facilities about postpartum family planning methods, including the postpartum intrauterine contraceptive device (IUCD). It has also included input from district managers from the Government of Pakistan’s health and population departments and has taught them how to provide appropriate and supportive supervision to health facility staff.
Building the capacity of nurses in healthy spacing of pregnancies, methods of contraception, and IUCD insertion techniques, the project’s achievements include an:
- Increase of uptake of interval IUCDs by 23%;
- Increase in number of clients counseled about family planning during antenatal care from 21% to 69% over six months; and
- Increase in immediate and post-placental IUCD insertions from zero to 717 between May 2012 and May 2013 across two provincial-level and six district-level facilities.
One of the health workers trained is 50-year-old Senior Nurse Midwife at Tehsil Headquarter Hospital, Zarina Bibi. During her participation in the program, Bibi has been providing her patients with lifesaving information on how to properly space their pregnancies and use a long-acting, reversible family planning method. Now, during prenatal care visits, she describes the benefits of family planning to pregnant women, reviews methods that may be appropriate for their families, and discusses the immediate insertion of an IUCD, if desired, after birth.
Tehsil Hospital sees between 120 and 150 births each month. Located in Mandi Bahauddin District of Punjab Province, a region with nearly 1.4 million people, the hallways are often filled with mothers and fathers holding babies and watching toddlers. Having more family planning options is critical to women in the region, as many have numerous children who are born within a year of each other. This increases the risk of complications for both women and their babies.
Rashida, age 45, met Bibi when she was pregnant with her thirteenth child. Rashida gave birth at the hospital, for the first time, after enduring a painful labor and losing her last baby during a home delivery less than a year earlier. During a prenatal visit, Bibi talked to Rashida about the dangers of recurrent, closely spaced pregnancies. She explained that using a family planning method could help Rashinda stay healthy as well as care for her other children and new baby.
“It was such new information for me that I can go home safe with a reliable family planning method immediately after delivery,” said Rashida. “I am really tired of getting pregnant almost every year and I have lost my energy to take care of my kids and family.”
Immediately following the delivery of Rashida’s baby, Bibi received consent and successfully inserted an IUCD. “Offering a family planning method immediately after delivery is such good news! Sending them back home safe in a single visit is amazing,” said Bibi. In the last six months, the hospital has provided 56 new mothers with IUCDs.
To further the success of this project and provide a comprehensive approach to improve health services for women, Tehsil Hospital works with Lady Health Workers, a group of female community health workers who visit women in their communities and talk to them about coming to the hospital for antenatal care and the delivery of their babies. This outreach allows the hospital to offer postpartum family planning services to a wider population.
Through postpartum family planning training programs, Jhpiego and the Packard Foundation hope to tackle the large number of Pakistani women who continue to die from repeated pregnancies and complications due to unsafe terminations while also empowering them to take control of their reproductive health and rights.
Photo via Jhpiego