RHL Commentary by Abraham Peedicayil
EVIDENCE SUMMARY
This review, completed in May 2001, was revised in May 2002 and assessed the effects of educating mothers postpartum about contraceptive use.
Methodologically the review is sound: the search strategy was comprehensive and well documented; only randomized and quasi-randomized trials were included; data were extracted and analysed appropriately; heterogeneity was checked for and the data were presented very well both in the text as well as in graphs. However, the lack of good quality studies limits the significance of the conclusions of the review.
Three trials from Lebanon, Nepal and Peru were included. The outcome variables were: attendance at family planning clinics and use of contraception at 40 days, nine weeks or three months post partum; and cessation of breastfeeding at three months post partum.
There was no effect on the rate of non-attendance at family planning clinics (Peto Odds Ratio (OR) 0.82, 95% Confidence Interval (CI) 0.56–1.21). Nor was there any evidence of an effect on the rate of cessation of breastfeeding at three months post partum (OR 1.00, 95% CI 0.67–1.48). There is a benefit of education on contraceptive use in the short and long term. The peto odds ratio for non-use of contraception up to 12 weeks was 0.47, 95% CI 0.39–0.58 and for non-use after 6 months was 0.52, 95% CI 0.37–0.74. However, when only the data from the good quality study conducted in Nepal were analysed, this beneficial effect was not any longer evident.
The full RHL commentary also includes sections on: Relevance
- Magnitude of the problem
- Applicability of results
- Implementation of the intervention
Research
References
This document should be cited as: Abraham Peedicayil. Education for contraceptive use by women after childbirth: RHL commentary (last revised: 17 December 2003). The WHO Reproductive Health Library, No 9, Update Software Ltd, Oxford, 2006. www.rhlibrary.com
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