Objective: Intention to use modern contraception in women with severe acute maternal morbidity (SAMM) presents a window of opportunity to scale up postpartum family planning to prevent future complications. The aim of this study was to determine the factors that affect the contraceptive intentions of women who survive SAMM in Kaduna State, northern Nigeria.
Methods: SAMM survivors aged 15-49 years were recruited after recovery and interviewed before discharge from hospital.
Results: Of the 330 women studied, 246 (74.5%) had wanted the index pregnancy. Although their knowledge of modern contraception was good (89.1%), only 44.5% had ever used modern contraception. The main reason given for not wanting to use modern contraception was that God should decide on the number of children. Injectables, pills, implants and male condoms were the commonest contraceptive methods used. Of the women who gave reasons for stopping these contraceptives, the main reasons in 61% were desire to conceive and fear of side effects. The majority (72.4%) of the women wished to have more children and 69.1% intended to use contraception in the future. The husband's permission was needed by 78.2% of respondents before using contraception. The commonest reason given for not wanting to get pregnant again was to avoid complications (30.4%) and that family size had been completed (28.6%).
Conclusion: Male partner involvement and counselling to address religious views and fear of side effects are critical to the acceptance of postpartum family planning in SAMM survivors.
Keywords: Contraceptive intentions; family planning; northern Nigeria; severe acute maternal morbidity.