Family Planning Needs of Women Experiencing Severe Maternal Morbidity in Accra, Ghana: Another Missed Opportunity?

Özge Tunçalp, Kwame Adu-Bonsaffoh, Richard M. Adanu, Michelle J. Hindin

Abstract

Women with severe maternal morbidity represent an important group to target for increasing contraceptive uptake. Our objective was to explore the future fertility intentions, use of family planning including methods and reasons for not wanting to use contraception among a group of women who had traumatic delivery experience at a tertiary teaching hospital in Accra, Ghana. Our results show that despite higher educational attainment, longer hospital stays and intention to limit or stop childbearing among women, there is a missed opportunity for family planning among women with severe maternal morbidity in this urban African hospital setting. Integrating postpartum family planning consultations by linking available services such as reproductive health clinics at the facilities rather than including additional tasks for the midwives and the doctors in the wards could be a sustainable solution in such urban, high-volume settings. (Afr J Reprod Health 2014; 18[2]: 15-21).

 

Keywords: near miss, maternal morbidity, family planning, postpartum contraception, Africa, integration, facility delivery

 

Résumé

Les femmes qui souffrent de la morbidité maternelle sévère représentent un groupe important à cibler pour faire avancer l'utilisation de la contraception. Notre objectif était d'étudier les futures intentions de fécondité, l'utilisation de la planification familiale, y compris les méthodes et les raisons de ne pas vouloir utiliser la contraception chez un groupe de femmes qui ont vécu l'expérience traumatique d’accouchement dans un Centre Hospitalier Universitaire à Accra, au Ghana. Nos résultats montrent que, malgré le niveau de scolarité plus élevé, de plus longs séjours à l'hôpital et l'intention de limiter ou d'arrêter de procréer chez les femmes, il y a une occasion manquée pour la planification familiale chez les femmes qui ont vécu la morbidité maternelle sévère dans ce milieu  urbain de l’hôpital africain. L’intégration des consultations de planification familiale post-partum en reliant les services disponibles tels que les cliniques de santé de la reproduction dans les installations plutôt que d'inclure des tâches supplémentaires pour les sages-femmes et les médecins dans les salles, pourrait être une solution durable, dans de tels milieux urbains et à volume élevé. (Afr J Reprod Health 2014; 18[2]: 15-21).

 

Motsclés: presque manqué,  morbidité maternelle,  planification familiale,  contraception post-partum, Afrique,  intégration, accouchement dans un établissement de santé

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