Evaluation of Postpartum Family Planning Counselling at Maternity Units in Enugu State

Postpartum family planning (PPFP) provides a critical opportunity to prevent closely spaced pregnancies and their associated maternal and neonatal risks, yet integration of PPFP counselling into routine maternity care at Enugu State facilities has not been evaluated. This study evaluates the content, quality, and uptake of postpartum family planning counselling at maternity units in Enugu State, South East Nigeria. Eleven maternity units in Enugu North, Enugu South, and Nkanu East LGAs were assessed through exit interviews with 220 postpartum women, direct observation of 40 postpartum counselling sessions, and structured interviews with 20 midwives and nurses. A postpartum family planning counselling quality score was computed based on method range, correct information delivery, and client-centred communication observed. Complete PPFP counselling covering at least three modern methods was delivered in only 27 percent of observed encounters. Progesterone-only pills and injectables were the most commonly discussed methods. Long-acting reversible contraception (LARC) was discussed in only 14 percent of counselling sessions. Immediate postpartum intrauterine device insertion was not offered at any facility. Women counselled in contraceptive options were 2.9 times more likely to adopt a postpartum method within six weeks. Professional recommendations include structured PPFP counselling checklists, LARC provider training, and immediate postpartum IUCD service introduction at Enugu State maternity units. Keywords: postpartum family planning, counselling quality, Enugu State, LARC, contraception