Counseling During Maternal and Infant Health Visits and Postpartum Contraceptive Use in Uttar Pradesh, India

CONTEXT: Women have a high unmet need for contraception in the year following a birth. It is important to examine whether providing family planning counseling as part of antenatal, intrapartum and postpartum maternal and infant health services is associated with postpartum contraceptive use. METHODS: Survey data from 2,733 women aged 15-49 from six cities in Uttar Pradesh, India, who had had a birth between 2011 and 2014 were used to examine associations between exposure to family planning information at maternal and infant health visits and contraceptive use in the postpartum period. Discrete-time event history multinomial logit models were used to examine any contraceptive use and method choice among modern method users in the 12 months following the last birth. RESULTS: Forty-six percent of women reported having used a modern contraceptive in the 12 months following their last birth during the study period; another 18% had used a traditional method. Among women who had delivered at a health facility, those who had received family planning counseling at that time were more likely than others to have used a modern method postpartum rather than no method or a traditional method (relative risk ratios, 2.0 and 2.3, respectively). Receiving a postpartum home visit by a community health worker that included family planning counseling was positively associated with modern method use rather than use of no method (1.3). CONCLUSION: Providing postpartum family planning counseling at the time of an institutional birth and during maternal health visits could increase women's uptake of a modern contraceptive method in urban Uttar Pradesh.