Abstract

PIP: This article discusses the role of counseling men in the postpartum period in addition to individual counseling and services for postpartum women. About 30% of couples rely on contraceptive methods that require men's active participation, such as condoms, vasectomy, withdrawal, or periodic abstinence. Communication between spouses about fertility and contraception and involvement of men in contraceptive services is constrained by cultural barriers, providers' lack of training on how to counsel men, health systems that discourage men from using services, and men's attitudes toward reproductive health. Counselors also must understand what husbands need to know and what women would like husbands to know. Couples need to know when women's fertility resumes in the postpartum period. Fertility returns shortly after an abortion (within 3 weeks) and after 6 weeks in postpartum women who are not breast feeding. Full breast feeding can delay the return to menses for 6 months. All male methods are appropriate in the postpartum period for breast-feeding women. Condoms are important for AIDS and sexually transmitted disease prevention. Natural family planning is unreliable until menstrual cycles become regular and ovulation resumes. Men need to be informed about family planning methods and about their own reproductive health. Men could be encouraged to help with child care and to value a girl child. Messages must be culturally specific and address the needs of both partners. Post-abortion counseling for men might address the issues of wives' need for recuperation, warning signs of complications, the importance of iron for prevention of anemia, and fertility return. Research findings indicate that counseling mattered, particularly in Turkey where the failure of withdrawal was related to repeat abortions. Brochures were the best means of conveying information to men.