Background Maternal mortality in Myanmar is one of the highest in the WHO South-East Asian region. Additionally, the country has a high unmet need for contraception and low rates of uptake of long-acting reversible contraceptive methods (LARCs) including intrauterine devices (IUDs) and implants. Engagement with health professionals around the time of a birth is an ideal opportunity for women to access contraception but immediate postpartum provision is not widely offered in Myanmar.
Methods We undertook a cross-sectional survey of women immediately postpartum at two hospitals in Yangon to investigate their knowledge, and past use of, contraceptive methods and their plans for postpartum contraception including perceptions of implants and IUDs. Four trained obstetrics staff collected data using electronic tablets between January 2017 and January 2018.
Results Of the 1755 participants, 55.1% had used pills and 42.2% injectables. In contrast, only 0.5% had used an IUD and 0.3% an implant. Few women (4.4%) anticipated starting contraception immediately postpartum and only a minority would consider future use of an implant (36.9%) or an IUD (13.0%). Fear of side effects was the major barrier to future implant and IUD uptake, reported by 64.5% and 62.5%, respectively.
Conclusions Women in maternity care in Yangon have some awareness of IUDs and implants but many hold misconceptions about their side effects leading to reluctance to use. Reducing the unmet need for contraception and improving maternal outcomes in Myanmar could be achieved by improving education, policy and practice around immediate postpartum contraception provision, with a particular focus on LARC methods.
- long-acting reversible contraception
- contraception behavior
- family planning policy
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Contributors HHY, KKN, CRG and KIB were involved in the study’s conception and funding. HHY, SHH and NKWY contributed to the methods and recruitment. HHY, NSM and KIB were involved in data analysis. KIB, CRG, HHY and NSM were involved in write up and all authors reviewed the final manuscript.
Funding This study was funded by a Cluster Research Grant from the Sydney Southeast Asia Centre that promotes and supports research in the region. The authors are grateful to the women who participated in this research.
Competing interests KIB was a member of an interational advisory board for Bayer Healthcare that examined postpartum insertion of intrauterine devices.
Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.
Patient consent for publication Not required.
Provenance and peer review Not commissioned; externally peer reviewed.
Data availability statement The data that support the findings of this study are available from the corresponding author, [KIB], upon reasonable request.
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