Volume 129, Issue 3 p. 256-259
Clinical articles

Contraceptive practice after surgical repair of obstetric fistula in southeast Nigeria

Lucky O. Lawani

Corresponding Author

Lucky O. Lawani

School of Post Graduate Studies, Department of Community Medicine, University of Nigeria, Enugu, Nigeria

Corresponding author at: School of Post Graduate Studies, Department of Community Medicine, University of Nigeria, Enugu, Enugu State, 400001, Nigeria. Tel.: + 234 8036691209.Search for more papers by this author
Chukwuemeka A. Iyoke

Chukwuemeka A. Iyoke

Department of Obstetrics and Gynecology, University of Nigeria Teaching Hospital, Enugu, Nigeria

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Paul O. Ezeonu

Paul O. Ezeonu

Department of Obstetrics and Gynecology, Federal Teaching Hospital Abakaliki, Abakaliki, Nigeria

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First published: 11 February 2015
Citations: 13

Abstract

Objective

To determine the contraceptive practices of women after surgical repair of obstetric fistula and to assess determinants of uptake and the pregnancy rate in the first year.

Methods

A prospective cohort study enrolled women who had a successful surgical repair of obstetric fistula at a center in Nigeria between 2011 and 2013. Patients were followed up for 1 year. Data were obtained through record review and completion of a semi-structured questionnaire.

Results

Among 188 participants, 180 (95.7%) were aware of contraception, but only 70 (37.2%) used contraceptive methods after surgery. The most commonly used methods were the male condom (50 [71.4%] of 70) and hormonal injections (14 [20.0%]). The main reasons for non-use were fear of adverse effects (48 [40.7%] of 118 women), future desire for more children (35 [29.7%]), religious prohibition (26 [22.0%]), cultural beliefs (29 [24.6%]), and partner disapproval (42 [35.6%]). The risk of unplanned pregnancy in the first year was significantly lower among women who used contraceptives than among those who did not (relative risk 0.14, 95% confidence interval 0.02–1.06; P = 0.03).

Conclusion

Contraceptive uptake for birth control after fistula repair surgery was low because of socioeconomic reasons, religious and cultural beliefs, and myths, resulting in unplanned pregnancies.