Postpartum Family Planning Counseling Gives Women More Choices
Through the ACCESS-FP program, health care providers and mothers in Albania are becoming increasingly aware of ways to prevent unplanned pregnancy. In a country where modern contraception was legalized as recently as 1992, and less than 10% of women use such a method, nurses and midwives are now being trained by ACCESS-FP to counsel new mothers on healthy spacing of pregnancies and what contraceptive methods are available to postpartum women.
“The first days after childbirth are very important,” says Norilda, a 24-year old mother nursing her newborn at the Queen Geraldine Maternity Hospital in Tirana, an ACCESS-FP supported facility. “You don’t know many things, you are unsure, and you need the advice of midwives. I did not use contraceptives before, but now I will be reading more, and will use a lactational amenorrhea method (LAM)[1] not to get pregnant, because I want to take good care of my daughter.”
Nurses and midwives trained by ACCESS-FP now include postpartum family planning counseling as a routine part of their daily responsibilities, along with teaching mothers how to breastfeed and care for their babies. During the first days after delivery, they provide women with family planning information and place posters on postpartum contraception in each room to help initiate discussions. Colorful leaflets that provide comprehensive information and reminders about these methods are also sent home with women to discuss with their husbands.
Until recently, there was little information available for Albanian women who wanted to know more about modern contraceptive methods and how to protect themselves from unplanned pregnancy. A 2008 assessment conducted by Jhpiego/ACCESS-FP in a Tirana maternity hospital revealed that 94% of postpartum women were interested in family planning information, but only 4% received it. When contacted 6 months after delivery, only 15% of them were using condoms, 77% were using a traditional method (e.g., withdrawal), and the remainder were not using any contraceptive method.
Although now legal, modern methods of contraception are slow to make their way into the lives of everyday Albanians. Due to widespread misconceptions that breastfeeding alone protects against pregnancy, and that fertility returns only with the resumption of menses, postpartum women are particularly vulnerable to unplanned pregnancy. Lack of evidence-based information and national clinical standards confound the problem.
According to the latest Reproductive Health Survey, half of Albanian women who have one child would like to delay the next birth for two years or longer, and approximately two-thirds of married women want no more children. The international medical community also recommends healthy spacing of pregnancies of at least two years between the birth of the child and the next pregnancy to benefit the mother and baby.
Through the continued support of the ACCESS-FP program, appropriate and comprehensive counseling on family planning is becoming part of routine postpartum care in Albanian maternity hospitals. This will help a new generation of Albanian women make informed decisions about family size and timing of pregnancies.
[1] A very reliable contraceptive method based on breastfeeding.
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