New twist to family planning programme Malathy Iyer, TNN, Mar 23, 2010,

MUMBAI: A new protocol was set up in J J Hospital’s labour room last week. A new mother was, within minutes of delivering her baby, given an empowering medicine, an intrauterine contraceptive that would help her decide when to have her next child, if at all.

In tune with the Centre’s latest mantra to boost family planning as well as spacing between two children, women, who so indicate, will be fitted with the intrauterine contraceptive device (IUCD) immediately after delivery in the labour room or within the next two days in the ward. Hitherto, the practice was to wait for a month when the mother came for a follow-up visit.

While the Copper T (the IUCD) is nothing new in the bouquet of contraception devices available, the dynamics are different. “Copper T is a time-tested and safe method. We have been doing it for decades but it was inserted in women who came to us with a normal-sized uterus,’’ said Dr Rekha Daver, head of the gynaceology department of J J Hospital.
But women who have just delivered have an enlarged uterus that could make the IUCD placement a bit delicate. “J J Hospital has been chosen as a centre to train healthcare officials from other states (Tamil Nadu, Karnataka and Andhra Pradesh) in the technique,’’ she said. A three-day training programme has just concluded in J J Hospital, with chief guests being Dr Jayalal Mohan, a family planning consultant with the Union ministry of health, and Dr Jeffrey Smith of the Johns Hopkins University.

But what brought about this change in the protocol? There is a two-fold explanation here. Firstly, new studies from across the world have recently indicated that IUCD immediately after delivery is safe. Secondly, for India, it could be a method of checking unwanted pregnancies.

“When you send a woman back home after delivery,’’ said Dr Mohan, “there is no guarantee that she will return a month later for a family planning intervention.’’ Incidentally, an Egyptian study showed that only one in 10 women returned a month later.

Moreover, at the time of delivery, women are motivated to have a family planning intervention. Said Daver, “Once they go home, they get caught in child-rearing and household chores and don’t bother about family planning until they come back to doctors with a missed period.’’

According to Smith, “The ideal space between two children should be three years so that the mother gets time to recover from the rigours of childbirth and prepare herself for the next one. But successive National Family Health Surveys have shown that 60% of India’s women have children within three years of the earlier one.’’