Informed Choices: Stories from PPIUD Clients in Bangladesh
Following five years of implementation since January 2015, FIGO’s Postpartum Intrauterine Device (PPIUD) Initiative is now wrapping up project activities and fully handing over responsibility for postpartum family planning (PPFP) services in the country to our partner, the Obstetrical and Gynecological Society of Bangladesh (OGSB). The project ran in six centres, with three outside of the capital and three within Dhaka.
PPIUD is an invaluable option for women postpartum in low-resource settings as it can be inserted immediately after delivery of the baby, meaning that women do not need to make regular and often long journeys back to health facilities to receive contraception.
Prof. Farhana Dewan, Deputy National Coordinator for the project in Bangladesh, spoke to two women who chose to receive a PPIUD to discuss their experiences of PPFP counselling and selecting the method.
“Prianka, aged 25, presented at our Antenatal Clinic (ANC) in July 2016. Prianka was counselled regarding PPIUD at the outpatient clinic; however, she initially chose not to go through with the procedure. When she came for her subsequent visit at the clinic, I counselled her again across all PPFP methods and, based on this knowledge, she decided to have a PPIUD inserted.
Prianka underwent an elective repeat caesarean section in October 2016. She delivered a baby girl and the IUCD was inserted. Both mother and baby were well in the post-operative period. She returned after 6 months for her follow-up and was found to be doing well. Clients are encouraged to keep in contact if they have any concerns with their PPIUD, even after the follow-up period. A few months after her follow-up, Prianka called her PPFP counsellor to discuss some irregular bleeding she was having, whereby she was advised to come into the hospital for an examination. Following the examination, we found that the IUD was still in place, evidenced by an ultrasound as no threads were visible. She was counselled properly on the reasons why she may be experiencing heavier bleeding and advised of future signs of concern to watch out for. Prianka still has the PPIUD now and is very contented with it."
“Anee, an 18-year-old woman, presented at our Antenatal Clinic for checkup in January 2019. Anee was a student, studying in university and wanted to continue her studies after giving birth. Anee was advised about birth spacing and postpartum family planning, and was given detailed explanations about all the available long-term methods. After her detailed counselling, she then decided she wanted to go ahead with PPIUD.
Mrs Anee was accompanied her husband in the subsequent visit, where he was also given information about the procedure. The process was explained in detail and one of our dedicated PPFP Counsellors, Mrs Dulu, counselled both the partners once more about PPIUD. A green sticker was marked on her ANC card and Anee signed her consent.
In July 2019, Anee delivered a female baby vaginally in the hospital and PPIUD was inserted. Both the partners including other family members are happy with the method and Anee is also advocating her relatives and other women to take up PPIUD."
Over the course of the project in Bangladesh, over 180,000 women have received comprehensive counselling on PPFP methods, resulting in 14,791 PPIUD insertions.
Increasing access to quality, rights-based contraceptive care is essential in empowering women to make informed decisions about their sexual and reproductive health, and has a direct impact on the reduction of maternal mortality and reaching Sustainable Development Goal 3.7.