Hidden barriers to FP integration in the postpartum and post-abortion setting: A case study from Peru

Using Peru as a case study, this presentation illustrates how supportive family planning (FP) policies can fail to deliver intended results, leaving women unprotected against unwanted pregnancy and high rates of maternal and child mortality. Participants will identify primary causes of unmet need for FP in Peru and assess effectiveness of a national FP guideline.

Data will be presented from a survey conducted in public health facilities in four regions of Peru between December 2006 and February 2007. This descriptive study investigated causes of unmet need in a convenience sample of 100 postpartum and 30 post-abortion patients. Survey data were collected through face-to-face interviews with patients.

A majority of unintended pregnancies among survey participants resulted from lack of contraceptive knowledge and fear of contraceptive side effects. Survey results revealed that, despite a national standard guaranteeing FP counseling for 100% of postpartum and post-abortion patients, 38.46% (95% CI 30.07 – 47.39) received no FP counseling. Of the 61.54% that did receive FP counseling, only 13% received high-quality services as defined by a modified version of Judith Bruce's quality-of-care framework.

Greater emphasis on the role of service providers in fulfilling evidence-based policies is warranted. The potential impact of integrating high-quality FP services into postpartum and post-abortion care in developing country settings is great, but strategies are needed to ensure that supportive policies deliver intended results.