Informed choice of contraception after an obstetric event Subcontract No. CI96.69A. INOPAL III final technical report.

This paper presents the final report of a diagnostic study that focused on the Mexican Institute of Social Security (IMSS) family planning/post-obstetric event program to identify factors such as provision of family planning without informed choice limited range of contraceptive choice and inadequacy of information and counseling which reduce the clients decision-making power. The study also assessed the degree to which requests for a postpartum method are met. Data were collected through interviews with service providers and women in 13 outpatient clinics and 13 hospitals in 12 states. Findings showed that more than one-third of the women did not receive information and counseling on contraceptive methods during prenatal care. About 70% of the women who had a recent delivery cesarean section or abortion received a contraceptive method at the hospital mainly an IUD or female sterilization. Of these women 4.5% stated that they had received a method they had not wanted and had not accepted. Concerning the informed consent program started by the IMSS over two-thirds of the providers interviewed had received training knew the program materials and over one-half were using the new form. These findings emphasize the need to strengthen training and supervision on informed consent procedures not only because one third of the providers have not received training but also because a large proportion of women reported having received methods without signing the form and signing it after the method had been delivered.