Prevalence and Factors Associated with Long-acting Reversible Contraception Initiation in Non-teenage Postpartum Thai Women Attending Siriraj Hospital

Objectives: To determine the prevalence of and factors significantly associated with long-acting reversible contraception (LARC) initiation among non-teenage postpartum women attending Siriraj Hospital. Materials and Methods: This prospective cross-sectional study was conducted at Family Planning and Reproductive Health Unit during June 2021 to January 2022. Thai women aged 20-45 years who requested postpartum contraception within 8 weeks after delivery were eligible for study enrolment. Results: Three hundred and seven postpartum women were included, but 3 women were excluded from analysis due to incomplete data. The mean age was 29.1 ± 5.6 years. Pregnancy complications were reported in 101 women (33.2%). The prevalence of postpartum LARC initiation was 27.6% (n = 84). The selected LARC method were, as follows: two-rod implant (11.8%), one-rod implant (10.9%), and intrauterine device (4.9%). Presence of pregnancy complications (adjusted odds ratio [aOR] 3.2, 95% confidence interval [CI] 1.21-8.44; p = 0.019) and interest in LARC (aOR 146.60, 95%CI 44.96-478.00; p < 0.001) were the factors independently associated with postpartum LARC initiation. Concern about the insertion procedure and complications or side effects related to LARC were cited as reasons for not requesting LARC initiation. Conclusion: The prevalence of postpartum LARC initiation among non-teenage Thai women at our centre was higher than the national prevalence of LARC initiation in Thailand. Presence of pregnancy complications and interest in LARC were identified as independent predictors of postpartum LARC use. The barriers to LARC initiation should be evaluated and managed to increase the rate of LARC utilization among interested women, but who harbour concerns about LARC.