Comparative Study of Effect of Couple and Woman-Only Counselling on Early Postpartum Contraceptive Uptake at a Tertiary Hospital in Ghana

Objective: To compare the effect of using couple counselling format (CC) and woman-only counselling format (WC) on early postpartum contraceptive uptake. Methodology: The study was a randomized experimental study, carried out at Korle-Bu Teaching Hospital between March and May 2019. Four hundred and twenty-two (422) women who were on admission and eligible for postpartum contraception uptake were recruited and 413 remained at the end of the study. Using simple randomization, the participants were either counselled with their spouses as dyad (couple counselling format - CC) or alone (woman-only counselling format -WC) using the Balanced Counselling Strategy plus toolkit.  They were followed up at 6 weeks postpartum to assess contraceptive uptake. Data regarding independent variables such as demographic, obstetric and contraceptive characteristics, format of contraception counselling used and contraceptive uptake which was the main outcome variable were collected for both arms. Data analysis was conducted, and p<0.05 was considered statistically significant.  Results: Early postpartum contraceptive uptake among the women in the CC arm was 64.42% and that of those in WC arm was 48.29% and the difference was significant (p<0.001). Lactational Amenorrhoea Method followed by long-acting reversible contraceptives (LARC) were the commonly used contraceptives by the women. The uptake of LARC was significantly higher among the CC arm compared to WC arm (p <0.001). Conclusion: Using couple counselling format in the early postpartum period significantly increased both contraceptive uptake and the use LARC within 6 weeks of delivery compared to using women only counselling format.