An association between Family Planning Method Used and Gynecological Morbidity in Women

Yogita Amit Hiwarkar¹* and Bhagwan Gamaji Ambhore²

¹^,2Assistant Professor, Community Medicine, Dr. Ulhas Patil Medical College and Hospital, Jalgaon Kh. (M.S.), India

ABSTRACT:

Background: It is essential to understand various determinants of gynecological morbidities. This would help in better planning and delivery of health care services. Invasive Family planning methods carry the risk of causing reproductive tract morbidity.

Objective: To study the association between use of contraceptive methods and presence of gyneacological morbidity among urban and rural women of reproductive age group

Material and methods: One hundred and seventy six and one hundred one women from urban and rural area respectively were included in the study. Information about presence of gynaecological morbidity and use of family planning method was gathered from sampled women.

Results: The gynecological morbidity was found to be more in women using invasive method of family planning both in urban (84.1%) as well as rural area( 92.53 %). The association between use of invasive FP method and presence of gynecological morbidity was found to be statistically significant in urban area (X² = 14.49, DF=1, P<0.001) and also in rural area(X² =16.04, DF=1, P<0.01).

KEYWORDS: Invasive family planning methods, gynecological morbidities

INTRODUCTION:

Gynaecological morbidities are determined by many direct or indirect factors. IUD insertions, unsafe abortions, childbirth and female genital mutilation, can all have a direct impact on morbidity. Reproductive morbidity in reference to the contraceptive (invasive and non invasive) use, covers conditions that result from efforts (other than abortion) to limit fertility, whether they are traditional or modern methods. Keeping in mind the above facts and as per recommendations of the WHO study group in 1957, that in order to obtain a comprehensive picture of a health problem / disease, only vital statistics is not sufficient, more and more such studies have to be undertaken, Garg Narendra K.(2) and Garg Narendra K.and Sharma A.B.(3), the authors have under taken this study with the objective to find the association between contraceptive method used and RTI/STIs

MATERIALS AND METHOD:

The present study was undertaken in an urban slum and in the field practice area of rural health training centre of Seth G.S. Medical College and K.E.M. Hospital, Parel, Mumbai. The study was conducted during September 2007 to November 2009. Reproductive age group (15-45yrs) married women living in study area were included while Widowed, divorced and separated women were excluded from the study

TABLE- I Association between Method of contraceptive use and Gynecological morbidity in study subjects in Urban area

Reproductive health Determinants		Gynecological morbidity present			Gynecological morbidity not present			Total
		n = 116		Row %	n = 60		Row %	n = 176*	Row %
METHOD OF CONTRACEPTIVE USED X² = 14.49 DF=1 P<0.001 (Statistically significant)**
Invasive	53		84.1		10	15.9		63	100.00%
Non invasive	63		55.8		50	44.2		113	100.00%

TABLE-II-Association between Family planning Method used and Gynecological Morbidity in study participants in Rural area

Reproductive health Factors	Gynecological morbidity present		Gynecological morbidity not present		Total
Reproductive health Factors	n = 81	Row %	N = 20	Row %	N = 101*	Row %
*Family planning method used X² =16.04 DF=1 P<0.01 (statistically significant )**
Invasive	60	92.53%	5	7.46%	65	100.00%
Noninvasive	21	56.75%	15	43.24%	36	100.00%

One hundred and seventy six and one hundred one women from urban and rural area respectively were taken as sample for the present study. House to house survey was done. Structured interview based on data collection instrument was conducted after taking consent. Information about use of family planning method was gathered. Invasive methods include IUCD and tubectomy, for analysis purpose all other methods (oral pills and condoms) and those women who did not used any method are clubbed together.

Inquiry about any of the symptoms related to Gynaecology morbidity was done. Clinical examination was also conducted on the above-mentioned sampled women.

OBSERVATIONS AND DISCUSSION:

The data thus collected were analyzed and interpretations were drawn. In urban area, 84 % of women using invasive method of family planning (e.g. IUD, Tubectomy) had some morbidity as compared to 56% of women who were using noninvasive method of family planning (e.g. hormonal pills, condom). The relationship was statistically significant with chi square value of 14.49 at DF=1 and P<0.01.

Similarly, in rural area, the morbidity was found to be more in women using invasive FP method (92.5%) than in women using noninvasive FP method (56.7%). The association between use of contraceptive method and presence of gynecological morbidity was found to be statistically significant with chi square value of 16.04 at DF=1 and P<0.01.

Similar to above findings, Bhatia JC et al (3) in his study mentioned that experience of obstetric problems and complications associated with the last live-birth, place of last delivery were found to have strong and pervasive influence on reported gynecological morbidity. Most importantly, reporting of the symptoms indicative of lower reproductive tract infections, acute PID and anemia were significantly higher among tubectomised women than among those who were not using any method of contraception or were using a reversible method.

CONCLUSION AND RECOMMENDATIONS:

From above observations and discussion, the authors reached to the conclusion that in both urban and rural invasive family planning method was determinant of gynecological morbidity.

Female accepting invasive method for contraception should be well informed of early signs of reproductive tract infections, ways, and measures to avoid it.

Multiparous women should be educated about the symptoms of gynecological morbidity particularly symptoms of genital prolapse.

REFERENCES:

(1) Garg Narendra K.: Evaluation of the impact of emesis and emesis plus purgation Therapy; Research J Pharmacology and Pharmacodynamics (2) March-April; 2010:201-202.

(2) Garg Narendra K and Sharma A.B.: Epidemiological profile of patients attending a tertiary care hospital, Muktsar,Punjab (India); Research J Pharmacology and Pharmacodynamics:3 (6)

(3) Bhatia JC, Cleland J. Self-reported symptoms of gynecological morbidity and their treatment in South India. Stud Fam Plann 1995; 26:203–16.

Received on 21.02.2013

Modified on 20.03.2013

Accepted on 08.04.2013

Research J. Pharmacology and Pharmacodynamics. 5(2): March–April 2013, 136-137