Improving postpartum contraception provision, particularly long-acting reversible methods of contraception, in low-resource, high HIV-prevalence settings such as Botswana will reduce unintended pregnancy and associated adverse consequences.
Adaptation of postpregnancy intrauterine device (IUD) insertion techniques for a low-resource setting alongside sustained supervision and mentorship until competence is achieved increases uptake of postpregnancy IUD.
Training all departmental healthcare providers in contraceptive counselling and method provision increases the uptake of postpartum long-acting reversible contraception methods and prevents a missed opportunity for contraception initiation.
The most impactful and cost-effective strategy to reduce maternal and perinatal mortality is to enable women to avoid unintended pregnancy. Provision of immediate postpartum contraception, promoted by the WHO, can avert more than 30% of maternal deaths and 10% of child mortality.