上海市已婚妇女初产后避孕方法的选择和转换

Contraceptive Method Choice and Switching among Married Women after First Birth in Shanghai

本文对上海市3701名已婚妇女初产后15个月内避孕方法的选择和转换进行了分析，分析结果表明：产后15个月内，95．46％的妇女采取过避孕方法。产后首次采取的避孕方法城市以避孕套（50．72％）和IUD（29．09％）为主，农村以IUD（56．65％）和避孕套（30．60％）为主，其它方法较少。首次避孕选择避孕套者，终止向IUD的转换率较高；而选用IUD者终止向其它方法的转换率较低。15个月随访时，94．54％的妇女正在使用某种避孕方法，其中60．76％的城市妇女71．07％的农村妇女正在使用IUD。多项分类Logistic回归分析结果表明不同特征的妇女对避孕方法的选择存在很大差异，城市、文化程度高的妇女倾向于选用避孕套和安全期，较少选用口服药；年龄大的妇女使用避孕套和安全期的人要多些；正在哺乳的妇女不愿用口服药；单位或计划生育部门对产后选用何种避孕方法有推荐意向的妇女使用IUD的比例较高。提示计划生育管理部门应根据妇女的不同特征耐心、细致、客观地向她们说明各种避孕方法的优点和缺点，需纠正社会上对一些避孕方法的偏见。应充分尊重妇女的避孕选择，使妇女自觉满意地实行计划生育。

3701 married women in Shanghai were followed up for 15 months after first birth to assess the choice and switching of contraceptive method. The results showed that during 15 months postpartum. 95. 46% of women had ever used a contraceptive method. Of these. 29. 09% of urban women and 56. 65 % of rural women chose IUD as their first postpartum contraceptive method. and 50. 72% of urban women and 30. 60% of rural women chose condom as their first postpartum contraceptive method. During 15 months postpartum. women whose first method was condom tended to switch to other methods, usually an IUD, while fewer women whose first method was an IUD switched to other methods. At 15th month follow-tip. 94.54 % of women were using a certain method. with 60. 76% of urban women and 71.07% of rural women using an IUD. Multinominal logistic regression analysis suggested that women’s characteristics influenced the choice of methods. Urban. well-educated women were more likely to choose condom and rhythm. and less likely to choose OCs. Older women tended to use condom and rhythm more often than younger women. Breast-feeding women were less likely to use OCs. Women who got recommendations regarding postpartum contraception from family planning providers were more likely to use IUD. It was concluded that family planning providers should increase women’s awareness of the benefits and disadvantages of different methods, dispel mystery and rumors about some methods and improve women’s informed choice.