Abstract

PIP: This article discusses postpregnancy programs that include family planning. Empirical evidence suggests that postpartum care is underused and does not include provision of contraceptive supplies before a hospital departure. Postpartum women have a need to space or limit childbearing that is not being met. The International Planned Parenthood Federation encourages affiliates to integrate family planning with other health services. The 1994 International Conference on Population and Development called for integrated services. The World Health Organization will be recommending, by the end of 1997, appropriate postpartum care for mother and baby. Family Health International recommends integrating family planning with maternal and child care. Many providers in Mexico, Chile, Zambia, and the Philippines are developing integrated postpartum services that include family planning. The FEMAP program in Mexico includes family planning information among its comprehensive prenatal care services. After delivery at FEMAP's seven hospitals or hospitals linked with FEMAP, health workers reinforce the messages given during prenatal visits. Then promoters visit mothers at home, provide more information, and urge regular postpartum check-ups along with child health check-ups. Almost 40% of FEMAP clients return for postpartum check-ups and about 80% receive prenatal care. The continuation rate is about 72% after 5 years. FEMAP offers a variety of long- and short-term options for contraception that satisfy women's needs. ICMER in Chile also offers integrated postpartum health services in poor neighborhoods. Programs can recommend methods suitable to women's needs. For example, the IUD is a good option for breast-feeding women. Lactational amenorrhea can be used in the immediate postpartum period. At 6 months, hormonal methods can be used. Providers must be sensitive to women's needs and sense of timing.