上海市城区产后妇女避孕节育状况及服务需求的调查

Status of Contraceptive Adoption and Service Demand Among Postpartum Women:A Survey in Shanghai Centre Communities

目的:调查上海市城区产后妇女避孕节育现状和服务需求,为完善社区计划生育服务模式提供依据。方法:采用横断面调查的方法,对上海市徐汇区10个街道的1819名产后1～2年妇女进行匿名封闭式问卷调查。结果:调查对象以户籍人口为主(78.4%)。对象产后月经和性生活的平均恢复时间为4.94个月和5.04个月,产后采用避孕措施的平均时间为5.68个月。91.5%妇女产后已经采用避孕措施,前3位方法为:避孕套(78.4%)、安全期(13.1%)、体外排精(10.9%)和宫内节育器(10.9%)。既往有人工流产史者占23.89%,产后意外妊娠总发生率为7.86%,其中本市户籍与外来产妇产后意外妊娠发生率分别为7.41%和12.79%,外来产妇产后意外妊娠发生率显著高于本市产妇,差异具有统计学意义(P<0.05)。82.9%的对象认为产后避孕宣教有必要,认为合适的产后避孕宣教应在产后访视和产后体检时,有33.3%的对象认为婴儿体检或免疫接种时可安排产后避孕宣教;希望获得的产后避孕宣教方式仍以宣传资料为主(87.2%)。结论:产后是及早落实避孕措施的关键时期,城区产后计划生育工作要针对产后妇女的特点和需求开展避孕方法的知情选择和宣教,以提高广大生育后期妇女生殖健康水平。

Objective： To investigate the status of contraceptive adoption, induced abortion and service demand among postpartum women, and provide practical advices to ameliorate service mode in communities for family planning/reproductive health. Methods： A cross - sectional study under the adoption of anonymous closed questionnaires was conducted among 1819 postpartum women from 10 communities at Xuhui district in Shanghai. Results： 78.6% of objects were registered permanent residence in Shanghai and the other were internal migrants. In postpartum women, the menstruation and sexual behavior resuming time were 4.94 and 5.04 months, respectively, and the average time of contraceptive adoption was 5.68months. Contraceptives were adopted among 91.5 % of postpartum women, which were sorted by ranking： condom （78.4 % ）, safe period（ 13.1% ） , withdrawl（ 10. 9 % ） , and IUD（ 10.9 % ）. 23.89% of women experienced induced abortion. The overall induced abortion rate of postpartum women was 8.27% including native（7. 33% ） and migrants（12. 78% ）. The induced abortion rate of migrants were significantly higher than that of native（P 〈 0.05 ）. 82.9% of women considered that it was necessary to publicize the health education of postpartum contraception which was welcome during postpartum follow - up and physical examination, especially at infant physical examination or immunization which was accounted for 33.3%. The mode of the health education of postpartum contraception was mainly publicity material（ 87. 2% ）. Conclusion： It is important to carry out postpartum contraception early. The informed choice and health education of contraception should be conducted according to the characteristic and demand of postpartum women.