| Objective:Through the investigation and analysis of related to postpartum contraceptive knowledge, postpartum home visit, health check-up at 42 days after delivery, the status and service demand of contraceptive adoption among postpartum service objects.To master the situation of postpartum visit, postpartum contraception adoption in Tianjin area. Provide scientific basis for improving community maternal health management and service model postpartum contraception. In order to reduce the incidence of postpartum unintended pregnancy and the risk of artificial abortion. Methods:From October 1, 2013 to November 10, 2013, 575 postpartum service objects from General Hospital of Tianjin Medical University and permanent hospital of Tianjin had been enrolled in this study. The questionnaire included general information and related knowledge of postpartume contraception. And begin a telephone follow-up at postpartum 42±7 day, 90±7day, 180 ± 7 day. The survey included postpartum home visit, health check-up at 42 days after delivery,postpartum lochia, breastfeeding, menstruation recovery situation, the status of contraceptive adoption, postpartum unintended pregnancy.The data were in putted and analyzed with SPSS for Windows Version17.0. Univariate using descriptive analysis calculations the rate, constituent ratio, mean, standard deviation; the count data using chi square test, the measured data was compared with the non parametric statistical method.Statistical significance was set at P<0.05. Results:1.The knowledge of postpartum contraception among postpartum service objects seriously lack: The total correct rate of the postpartum service objects was 26.8%. The lowest score is 0 points, the highest was 70 points. The average score was 27.67±13.48. > 60 points accounted for only 2.6%.Which related to the IUD, progestin-only contraceptives, compound hormonal contraceptives, LAM correct rate, accounted for 31.1%, 18.6%, 23.7%, 44.9%, respectively.2. The postpartum home visit and health check-up at 42 days after delivery of service objects(1)The rate of postpartum home visit and health check-up at 42 days after delivery among postpartum service objects: The rate of postpartum home visit was 94%, the rate of health check-up at 42 days after delivery was 89.0%,there were significant differences statistically(P<0.05).(2)The postpartum visit content was imperfect among service objects: During postpartum 3-7 days home visit, conductde puerperium health guidance was72.0%, Only 50.7% of postpartum contraception propaganda and guidance; During health check-up at 42 days after delivery, 78.3% of the guidance on how contraception, sexual health, there are 60.2% prevention of reproductive tract infections, and there are 72.0% of the guidance of exclusive breastfeeding for six months.(3) health check-up at 42 days after delivery of service objects understand ways:52.5% of community hospital and delivery hospital notified,31.3% of community hospitals notice, 0.8% no notice.(4) Service objects favorite form of contraception propaganda: 64.6% of service objects like issuing brochures and materials; 17.4% like to counsel doctors and nurses; 13.4% like hotline.(5) The best time to postpartum contraception propaganda: 51.3% believe that health check-up at 42 days after delivery; 29.9% of the postpartum 3-7 days home visit; 16.6% of the antenatal examination.3. Postpartum breastfeeding of service objects: The rate of breastfeeding was 86.5%, of which 71.9% of full breastfeeding, 14.7% of mixed feeding, 13.5% of artificial feeding. 40.0% full breastfeeding adhere to 6 months postpartum.4.The relationship of postpartum menstruation recovery and feeding:To 6 months postpartum, 58.4% of postpartum menstruation recovery in full breastfeeding of service objects, 73.0% of recovery in mixed feeding, 100% of recovery in artificial feeding. Effect of different feeding patterns for comparison of menstruation recovery,there were significant differences statistically(P<0.05).5. The situation of postpartum contraception adoption among service objects(1) To 6 months postpartum, there are 95.6% of the service objects have been restored sex life, the average time of restored sex life and started using contraceptive measures was 81.69±35.00 days,98.44±39.13 days. Postpartum restored sex life without and did not immediately contraceptive have 27.3%, to 6 months postpartum, which can rely on LAM contraception have 43.2%. The main reason for the investigation did not immediately contraception: menstruation which is no recoverydoes not pregnant, small number of sex life dose not pregnant, lactation dose not pregnancy, accounted for 44.7%, 24.2%, 22.7%, respectively.(2) Contraceptives adoption of postpartum service objects were sorted by ranking: condom(83.2%), withdrawl(1.8%), IUD(1.8%), safe period(1.6%).(3) To 4 months postpartum, service objects which can rely on LAM contraception have48.3%,to 5 months have20.8%. To 6 months have 20.8%.6. present satisfaction of contraception state among service objects: 57.3% of satisfied, 23.2% of general satisfaction, only 1.9% dissatisfied. Conclusions:1. The rate of postpartum home visit and health check-up at 42 days after delivery among postpartum service objects was better, but the visit content was imperfect.2. The average time of started using contraceptive measures lags behind the time of restored sex life.27.3% of service objects first sexual exposure to hazardous under no contraceptive measures.3. Contraceptives adoption of postpartum service objects were sorted by ranking: condom, withdrawl, IUD, safe period. To 6 months postpartum, service objects which can rely on LAM contraception have20.8%.4. The knowledge of postpartum contraception among postpartum service objects seriously lack. During postpartum visit, the propaganda and guidance for postpartum contraception was insufficient.5. Service providers can through the issuance of brochures and materials, encouraging service objects to counsel doctors and nurses, relevant departments to establish postpartum contraception hotline to carry out propaganda and guidance for postpartum contraception.6. The time of propaganda and guidance for postpartum contraception shoud be focused on the health check-up at 42 days after delivery and the postpartum 3-7 days home visit. |
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