Main Organiser

Julius Centre University of Malaya

Co-organiser

Department of Social and Preventive Medicine, Faculty of Medicine, University of Malay

Supported by

University of Malaya

LOOKING AT AN INSIGHT OF CONTRACEPTIVE METHOD CHOICE AMONG POSTNATAL WOMEN IN A TERTIARY HOSPITAL IN MALAYSIA

Author

Si Lay Khaing , Tin Tin Su, Syariza Shahar , Noor Azmi , Siti Zawiah Omar

Institution

University of Malaya

Abstract

Objectives: To determine the factors influencing contraceptive method choice among postnatal women in a tertiary hospital in Malaysia.

Methods: This is a cross-sectional study using face- to-face structured questionnaire interview, which was conducted in University Malaya Medical Centre (UMMC) in Kuala Lumpur during the period of May 2008 and July 2008. A universal sampling method was used. All women who delivered in UMMC during the studied period and fulfilled the criteria were included in the study. There were 407 participants in the questionnaire survey and it was 100% respond rate. Data from the interviews were entered and analyzed by using the Stata version 9.0. Descriptive, bivariate and multivariate regression analyses were done.

Results: The mean age of the respondents was 29.8 (±5) year, and of their partners was 32.5 (±5.66) year. About two third of the participants are Malay Muslim. 45.21% respondents and 44.47% of their partners had an education up to the tertiary level. At the time of the interview, 71.25% and 99.51% of the respondents and their partner still held a job position with mean total income of RM 3609 (±2511.34). Majority of Malay respondents wish to have maximum of three or more children (74.9%), followed by Indian (70.75%) and Chinese (54.68%) ethnicity. Mean number of children desired by Malay, Indian and Chinese parents were 3.35, 3.0 and 2.9 respectively. 176 (43%) respondents answered that they had no prior usage of contraceptive. 15% of post natal women used hormonal method either oral or injectable form. Natural method, and barrier and IUCD methods were among the most used contraceptive method 30% and 12% respectively. As a result of not using any contraceptive, 44.72% of respondents had last child birth within a year back and majority (86.73%) had experiences at least one miscarriage before. Among the respondents, 137 (34%) were undecided or no intension to use contraceptive in future. 103 post natal women (25%) had intention to use hormonal contraceptives either as an oral or injectable form. The natural method was a method of choice for 20% of respondents while 21% preferred barrier and IUCD methods. A multinomial logit model was applied in order to estimate the probability of choosing a contraceptive method for the future. The younger respondents used the hormonal method than other methods. The usage of natural contraceptive method was highest among women who desired higher number of children. Malay respondents planned to practice the hormonal method and they did not prefer IUCD and the barrier method. Only women with partners of semi professionals and the professionals chose the natural method. Women who previously used the natural contraception were more frequently used the same method in the near future. Similarly, they also tend to switch to other methods, but to a lesser extend of likelihood. Women who used the IUCD and the barrier method had a likelihood of continue using the same method and did not intend to switch to other methods. Individuals who had used the hormonal contraception were seen to be choosing the same method in the future and also plan to use IUCD and the barrier method. The preference of the partner positively influenced on choosing the hormonal method. The free availability of contraceptives did not play an important role in choice of contraceptive method.

Conclusion: The effective contraceptive usage prevents unplanned pregnancy, however, as we found, taking up or actual usage is still lower in Malaysia. The proper counseling can provide and guide them to make right decision for suitable method for individual couple and in turn, improve the reproductive health of Malaysian population.