Antenatal Counselling For PPIUCD Success: Role of Antenatal Counselling For PPIUCD

Abstract

Background:
The postpartum intrauterine contraceptive device (PPIUCD) is a highly effective, long-acting, reversible method of contraception ideal for the immediate postpartum period. Despite its benefits, PPIUCD utilization remains low due to misinformation, fear, and lack of counselling. Antenatal counselling has emerged as a potentially transformative strategy to enhance acceptance and uptake of PPIUCD.

Aim:
To evaluate the effectiveness of structured antenatal counselling in improving the acceptance and insertion rates of PPIUCD and to assess barriers to acceptance among women who were not counselled.

Methods:
A prospective interventional study was conducted at Mettupalayam Government Hospital from July to September 2025. A total of 200 antenatal women were recruited using convenience sampling. Participants were divided into those who received structured antenatal counselling (n=128) and those who did not (n=72). Data on acceptance, insertion, and refusal were collected and compared.

Results:
Among counselled women, 93.7% accepted PPIUCD and 85.1% underwent insertion, compared to 33.3% and 19.4% respectively in the non-counselled group. Refusal was significantly higher (66.7%) in the non-counselled group compared to 6.3% in the counselled group. The most common reasons for refusal included fear of pain, myths about infertility, and family disapproval.

Conclusion:
Structured antenatal counselling significantly improves both acceptance and successful insertion of PPIUCD. Integration of PPIUCD counselling into routine antenatal care is essential for strengthening postpartum family planning and reducing unmet contraceptive needs.