#12161. Provider and Women Characteristics as Risk Factors for Postpartum Copper IUD Expulsion and Discontinuation in Nepal

July 2026publication date
Proposal available till 25-05-2025
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Journal’s subject area:
Sociology and Political Science;
Obstetrics and Gynecology;
Public Health, Environmental and Occupational Health;
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Abstract:
Providers and womens characteristics are associated with postpartum copper IUD (PPIUD) outcomes, but the relationship between providers level of experience and PPIUD expulsion and discontinuation has not been established. Randomized trial data on PPIUD counseling were used to identify associations between providers and womens characteristics and PPIUD outcomes. Multinomial logistic regression models were used to estimate PPIUD expulsion and discontinuation risks. It was found that having a provider who had done at least 10 previous insertions was associated with lower risk of expulsion rather than continuation relative to having a less-experienced provider. Women had a higher risk of both expulsion and discontinuation relative to continuation if they were under 21 rather than aged 26-30. Women whose husbands did not live at home also had elevated discontinuation risks. The findings highlight the need for increased training and supervision of providers during their first 10 PPIUD insertions. Counseling on the risk of expulsion may especially benefit younger women and should include partners and other family members to avoid any stigma surrounding PPIUD use by women whose partner is away from home for a prolonged period.
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