Return to Sexual Activity and Modern Family Planning Use in the Extended Postpartum Period: An Analysis of Findings from Seventeen Countries

Research has shown that family planning use during the first year postpartum has the potential to significantly reduce unintended pregnancies. This paper examines the relationship between menses return, breastfeeding status, and postpartum duration on return to sexual activity and use of modern family planning among postpartum women. The analysis is based on secondary data from 17 Demographic and Health Surveys (DHS) conducted in various countries. The sample population includes in-union women who had a birth in the 12 months preceding the survey. The analysis focuses on the following factors: return of menses, breastfeeding status, postpartum duration, return to sexual activity, and use of modern family planning. The results show that return of menses, breastfeeding status, and postpartum duration are significantly associated with return to sexual activity in at least 10 out of the 17 countries. However, these factors are not consistently associated with family planning use. Only return of menses has a significant association with use of modern family planning in the majority of countries. The study highlights the importance of education about pregnancy risk prior to menses return. The findings suggest that women are frequently fecund postpartum before they realize it, and that many women do not initiate use of family planning until after menstruation has resumed. The study also notes that breastfeeding practices can affect return of menses, and that return of menses has been shown to affect uptake of contraception. The analysis uses bivariate and multivariate analyses to examine the relationship between the factors mentioned above. The results are presented in the form of weighted cross-tabulations and logistic regression models. The study's findings have implications for programs aimed at increasing access to family planning services among postpartum women. The study's sample population includes women from 17 countries, including Bangladesh, the Democratic Republic of Congo, Ethiopia, Ghana, Guinea, Haiti, India, Kenya, Madagascar, Malawi, Mali, Nigeria, Pakistan, Rwanda, Tanzania, Uganda, and Zambia. The sample sizes for each country are listed in Appendix Table 1. The study's findings have implications for programs aimed at increasing access to family planning services among postpartum women. The results suggest that education about pregnancy risk prior to menses return is critical, and that programs should focus on increasing access to family planning services during the postpartum period. The study's findings also highlight the importance of breastfeeding practices in affecting return of menses and uptake of contraception. The study's methodology involves secondary data analysis of 17 DHS conducted in various countries. The analysis focuses on the relationship between return of menses, breastfeeding status, postpartum duration, return to sexual activity, and use of modern family planning. The results are presented in the form of weighted cross-tabulations and logistic regression models. The study's results are consistent with previous research that has shown that family planning use during the first year postpartum has the potential to significantly reduce unintended pregnancies. The study's findings also highlight the importance of education about pregnancy risk prior to menses return, and the need for programs to focus on increasing access to family planning services during the postpartum period.