Objectives: To explore the main determinants of the reproductive behavior of nursing mothers, all inhabitants of the central part of the European region of the Russian Federation, their use of modern contraceptive methods and their attitude to future family planning.
Methods: Open cohort multicenter study of 1200 nursing mothers aged 16-42 years interviewed at 3-5 days' postpartum, with subsequent longitudinal monitoring ofthe majority in the local family planning centers during the 2 years after labor.
Results: The main determinants of the reproductive behavior of this cohort of women are an early debut of sexual activity, several partners in their reproductive history, relatively early marriage with a motivation to have one child in their family and the tendency to use induced abortion as one of the methods of birth regulation. Our experience of postpartum counselling demonstrated positive changes in the women's attitudes to modern contraceptive methods. The data reveal that the induced abortion rate among 639 mothers regularly followed-up during the first year postpartum was 4.4%, and among 606 during the second year was 5.1%. The corresponding rates among 129 women who did not visit the family planning centers and who were only interviewed 2 years after labor were 9.3% and 8.5%, respectively.
Conclusions: Our data show that the unmet needs are remarkably concentrated among women who have given birth within the last year or two, and who need augmented attention from the family planning and reproductive health services.