Postpartum intrauterine device (PPIUD) use remains very low in Nepal despite high levels of unmet need for postpartum family planning and the national government’s efforts to promote its use. This study investigates reasons for continuing or discontinuing PPIUD use among Nepali women. We conducted in-depth interviews (IDIs) with 13 women who had discontinued PPIUD use and 12 women who were continuing to use the method 9 months or longer following the insertion. All interviews were audio recorded, transcribed, translated into English, and analyzed using a thematic approach. Women discontinued PPIUD for several reasons: 1) side effects such as excessive bleeding during menstruation, nausea, back and abdominal pain; 2) poor quality of counselling and, relatedly, mismatched expectations in terms of device use; and 3) lack of family support from husbands and in-laws. In contrast, women who were continuing to use the method at the time of the study stated that they had not experienced side-effects, had received appropriate information during counselling sessions, and had the backing of their family members in terms of using PPIUD. Experiencing side-effects or complications following PPIUD insertion and poor quality of family planning counselling were the two main reasons for discontinuation. Family members appeared to play a major role in influencing a woman’s decision to continue or discontinue PPIUD suggesting that counseling may need to be expanded to them as well. Improving quality of counselling by providing complete and balanced information of family planning methods as well as ensuring sufficient time for counselling and extending PPIUD service availability at lower level clinics/health posts will potentially increase the uptake and continued use of postpartum family planning, including PPIUD, in Nepal.

中文翻译：

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探索尼泊尔停止使用产后立即宫内节育器的原因：一项定性研究

尽管产后计划生育的需求未得到满足且国家政府努力促进其使用，但尼泊尔的产后宫内节育器 (PPIUD) 使用率仍然很低。本研究调查了尼泊尔妇女继续或停止使用 PPIUD 的原因。我们对 13 名已停止使用 PPIUD 的女性和 12 名在插入后 9 个月或更长时间继续使用该方法的女性进行了深度访谈 (IDI)。所有采访均进行录音、转录、翻译成英语，并使用主题方法进行分析。女性停止使用 PPIUD 的原因有几个：1）副作用，如经期出血过多、恶心、背部和腹部疼痛；2) 咨询质量差，以及相关的设备使用期望不匹配；3）缺乏丈夫和姻亲的家庭支持。相比之下，在研究时继续使用该方法的女性表示，她们没有出现副作用，在咨询过程中收到了适当的信息，并且在使用 PPIUD 方面得到了家人的支持。植入 PPIUD 后出现副作用或并发症以及计划生育咨询质量差是停止治疗的两个主要原因。家庭成员似乎在影响女性决定继续或停止 PPIUD 方面发挥着重要作用，这表明咨询可能也需要扩大到她们。通过提供完整和平衡的计划生育方法信息以及确保有足够的咨询时间和在较低级别的诊所/卫生站扩大 PPIUD 服务的可用性来提高咨询质量，将有可能增加产后计划生育的采用和持续使用，包括 PPIUD、在尼泊尔。