Permanent Contraception: Women's Desire for Their Spouse and Future Uptake

Permanent contraception (PC) is a safe and cost-effective irreversible method of preventing unwanted pregnancy and reducing maternal morbidity and mortality. Only 0.2% of women use PC in Nigeria. This study aimed at assessing women's knowledge, their desire for spousal and future uptake of permanent contraception.

A cross-sectional survey conducted among 256 antenatal attendees at University College Hospital, Ibadan, Nigeria, using semistructured self-administered questionnaire. Logistic regression analyses were used to determine factors associated with women's desire and spousal uptake of PC at 95% confidence interval (CI) with a p value of ≤ 0.05.

All were aware of PC and majority (180 [70.3%]) had good knowledge of it. About a quarter (26.5%) of the women wish to use PC once they complete their family size with more than half (52.6%) of them willing to use it after four or more children. Only 28.9% will allow their spouse to have vasectomy. Commonest reasons for PC future uptake are completed family size (88.9%) and economic challenges (45.5%). Those with one living child were less likely to have a good knowledge of PC (AOR = 0.527 and 95% CI = 0.278-0.998) and those with fertility issues were twice more likely to have good knowledge (AOR = 2.373 and 95% CI = 1.030-5.466). Respondent's perception of PC (p < 0.001) and "ever had pregnancy complications" (p = 0.014) are associated with their desire for spousal uptake.

There is a high level of awareness and good knowledge of PC; however, just a few will use it or allow their spouse to use it in future. There is a need to strengthen counselling and maternal education on PC with the aim to improve its uptake.