Informed choices: PPFP in Nepal


FIGO’s Postpartum Intrauterine Device (PPIUD) Project has been running in Nepal since 2015 in association with the Nepal Society of Obstetricians and Gynaecologists (NESOG).The initiative trains healthcare providers in postpartum family planning counselling and the insertion of postpartum intrauterine devices (PPIUD).

On a recent trip, we spoke to local women who have been counselled as part of the programme, and asked what having access to postpartum family planning means to them and their community.

My name is Rita Shrestha. I am 23 years old. This is my first baby.

When I was pregnant I came for immunization at the Maternal and Child Health Centre (MCH). They counselled me about all the methods and at that time I liked PPIUD. I was counselled again during the time of delivery by a nurse.

Initially, I didn’t know about any other methods. When I inquired I found that PPIUD does not cause any infection, no bleeding occurs. They counselled me on other devices also, some that you put in your arm, and I felt afraid of it. When I listened to all the advantages, I liked PPIUD the most.

It’s important for women to have a choice of family planning methods because it is the woman who uses the device, so it should be her choice. The woman needs to be comfortable with the device she is using. Using family planning is directly related to women’s health.

I will recommend PPIUD to other women, I need to say good things [about this method] to all of them. It does not cause infection or major side effects, it does not invite any kind of disease.

Low cost, long-acting reversible contraceptives (LARCs), such as the intrauterine device (IUD), can be very effective in facilitating birth spacing. A copper IUD can be inserted immediately after delivery and can prevent pregnancy for up to 10 years. Postpartum IUD insertion is particularly advantageous because it does not interfere with breastfeeding and is associated with less discomfort, lower risk of perforation of the uterus, and fewer adverse side effects than interval IUD insertion.

PPIUD is an invaluable option for postpartum women in low-resource settings as it can be inserted immediately after delivery of the baby – meaning the woman does not have to make regular and often long journeys back to the health facility to receive contraception.

Increasing access to quality, rights-based contraceptive care is essential in empowering women to make informed decisions about their sexual and reproductive health, and has a direct impact on the reduction of maternal mortality.

Sustainable Development Goal 3.7 aims to ensure universal access to sexual and reproductive health care services, including for family planning, information and education, and the integration of reproductive health into national strategies and programs. The PPIUD Initiative is therefore directly contributing to this indicator and FIGO will continue to support our member societies to meet these targets.