The State of Postpartum Contraceptive Use in India: Descriptive Lessons from Nationally Representative Survey Data

Nicole Johns, Center on Gender Equity and Health, UC San Diego
Abhishek Singh, International Institute for Population Sciences (IIPS)
Shruti Ambast, University of California, San Diego
Nandita Bhan, Jindal School Of Public Health And Human Development (JSPH), O.P. Jindal Global University
Katherine Hay, Center on Gender Equity and Health, University of California San Diego
Vedavati Patwardhan, Center on Gender Equity and Health, UCSD
Lotus McDougal, Center on Gender Equity and Health, UCSD

Postpartum contraception is a key tool to delay or prevent subsequent pregnancy after birth. Though prior research has demonstrated substantial dynamism in contraceptive use throughout the postpartum period, most measurement of postpartum contraception has focused on aggregate use of any method at a single time point. We sought to more thoroughly examine the continuum of postpartum contraceptive use amongst women in India using 2019-21 National Family and Health Survey reproductive calendar data. We present estimates of postpartum contraceptive use by month postpartum, use of specific methods, initiation, duration, stopping, method switching, and subsequent pregnancy. We find that 59% of Indian women used a method of contraception within the first year postpartum, that condoms and female sterilization were the most commonly used methods, and that patterns of postpartum contraceptive use differed substantially by month, method, and subpopulation. Among postpartum contraceptive users, 9% switched methods, 19% stopped using contraception entirely, and 5% had another pregnancy within the first year postpartum. The dynamic nature of postpartum contraceptive use suggests limited value of static contraceptive uptake targets, whether for program planning or as measures of success, and bolsters the need to center and to improve reproductive agency, empowerment, and access throughout the postpartum period.

Keywords: Family Planning and Contraception, Sexual and Reproductive Health and Rights

See paper.