Time interval to initiation of contraceptive methods following childbirth in a low-resource setting.

OBJECTIVES: The objectives of the study were to determine factors affecting the interval between a woman's last childbirth and the initiation of contraception. MATERIALS AND METHODS: This was a retrospective study. Family planning clinic records of the Barau Dikko Teaching Hospital Kaduna from January 2000 to March 2014 were retrieved. Information was collected on demographics, reproductive, and contraceptive history. Data were analyzed using the SPSS version 15 software, and missing responses were excluded. Chi-square was used as a test of association with significance level established at P = 0.05. RESULTS: A total of 5992 client's cards were retrieved. All were female and married. Majority were aged 25-34 years (53.1%), had completed secondary education (56%) and were Muslims (52.3%). Only 4979 cards (83.1%) had correct data on intervals and 22.1% of these clients initiated contraception within 6 months of their last childbirth. Education, religion, source of information, number of living children, desire to have more children, previous use of contraception, and type of contraception chosen were significantly associated with intervals for initiating contraception after last childbirth (P < 0.05) while the presence of complications in the last delivery was not (P > 0.05). CONCLUSIONS: Majority of women initiate contraception late after childbirth in this setting. Increased awareness on immediate/early postpartum contraception is required. Further qualitative studies will help to explore findings of this study.

Reproductive health in Nigeria.

BACKGROUND: Adolescents have special reproductive health needs, but these peculiar needs are often unmet in many cultures and countries. METHODS: A cross-sectional study involving adolescents in three secondary schools in a northern Nigerian setting. Demographic characteristics as well as reproductive health issues (adolescent sex, abortion, sexual experience) among the students were surveyed. RESULTS: Of the 1070 students that fully participated in the survey, 539 (50.4%) were girls and 531 (49.6%) boys. They were aged 10 - 27 years (median 16 Years). Five hundred forty three (50.7%) were Christians and 499 (46.6%) Muslims. Nine hundred and four (84.5%) of the students knew about abortion. On their view about reasons why adolescents indulge in premarital sex, 574 (53.6%) felt it was to please boyfriend/girlfriend, 391 (36.5%) to experiment with sex, 312 (29.6%) to test fertility and 239 (22.3%) felt it was to stop painful menstruation. One hundred thirty five (12.6%) have had sex and 15 - 19 years age group were more likely to be sexually active. Twelve (1.1%) of the girls had been pregnant once - four times before and all had an abortion. Children of civil servants were significantly more likely to be sexually active compared to other groups of children (p <0.05). All the respondents knew one or more complication of abortion to include inability to get pregnant in future 682 (63.7%), abdominal pain 589 (55%) and painful menstruation 427 (39.9%). CONCLUSION: Adolescents are unique in every way including issues of reproductive health. The age at sexual debut in this setting is early. There is a need to include reproductive health education in the curriculum of secondary schools. This should help the adolescents to obtain the correct information from the right source.

Fertility and obstetric outcome after caesarean myomectomy.

This is a prospective non-randomised study to determine the fertility performance and pregnancy outcome in pregnant females who had caesarean myomectomy at last delivery. A total of 29 females were studied and they had a mean age of 37.3 years. Of these, 22 (75.9%) of the females were para 1 and 25 (86.2%) had had one previous caesarean section. Only six (20.7%) of them had fertility treatment before the attainment of the index pregnancy. The common antenatal complications recorded were abnormal lie/malpresentation (10.3%), placenta praevia (10.3%) and threatened abortion (10.3%); 17 patients were eligible for trial of scar; 13 (44.8%) had successful vaginal birth after caesarean myomectomy, while 16 (55.2%) had repeat caesarean section including a caesarean hysterectomy. Postoperative morbidity was recorded in four (25%) of the 16 patients that had abdominal delivery. There was no maternal or perinatal mortality recorded. The future fertility and or subsequent pregnancy outcome in patients is unaffected by caesarean myomectomy.