INTRODUCTION: Immediate PostPartum Family Planning (PPFP) is the initiation
of Family Planning (FP) methods within 48 hours after delivery. Its uptake remains
low in sub-Saharan Africa, including Rwanda. This study aimed at analyzing use
and identifying motivators and barriers leading to immediate PPFP acceptance
among Rwandan women at Kacyiru Hospital (KH), Kigali, Rwanda.
METHODS: This was a qualitative study conducted on postpartum mothers from
1st September to 31st October 2018. The participants were selected by purposive
and convenience sampling with respected ethical considerations. In-depth interviews
were used to identify themes.
RESULTS: A total of 28 women were enrolled for in-depth 45-minute interviews.
Among them, 19 participants accepted and nine refused immediate PPFP. Motivators
identified were: Socio-economic reasons, awareness of complications to closely
spaced pregnancies, time to breastfeed, peer motivation, prevention of multiple
hospital visits, cesarean delivery, freedom to unprotected sex, avoidance of family
conflicts, being responsible, confidence in stopping contraception at any time and
old age. Barriers were: Perceived poor efficacy and side effects of contraceptive
methods, belief of inability of getting pregnant after delivery before resuming
menses, religious belief, husband/partner’s opinion, fresh cesarean wound, peer
demotivation, and first pregnancy.
CONCLUSION: Immediate PPFP uptake is affected with intrinsic and extrinsic
factors. Partners and the community (peers) play a role in process of making decision
among women who deliver at Kacyiru hospital. Accelerating male participation and
engaging with the wider community through innovative strategies that compete with
misinformation would improve partnerships with religious leaders.