THE EFFECTS OF HYBRID FAMILY PLANNING COUNSELING IN THE POSTPARTUM PERIOD ON MATERNAL HEALTH: A LONGITUDINAL STUDY

Postpartum family planning is an approach that aims to encourage women to have at least 24 months between pregnancies, starting within the first 6-24 hours after delivery. Within this scope, providing appropriate contraceptive methods within six weeks of delivery, even if the woman is breastfeeding or amenorrhea, and providing couples with counseling on sexual health issues are among the basic practices.

A pregnancy immediately after delivery increases the risk of pregnancy complications, shortens the duration of breastfeeding, and jeopardizes maternal and child health. While the World Health Organization (WHO) recommends that the time between two pregnancies should be at least 24 months for the physiological and psychosocial health of the mother in the postpartum period, the American College of Obstetrics and Gynecology (ACOG) recommends that this period should be 18 months.

Family planning; It encompasses all techniques and practices aimed at helping couples have children of their own free will, at the time and in the number they desire, determining the interval between pregnancies, and preventing unwanted pregnancies. Because the exact timing of resuming sexual activity in the postpartum period and the duration of fertility in breastfeeding women are not precisely known, the most appropriate time for contraceptive method counseling is the antenatal period. If the mother has not made a decision about contraceptive methods during this period, the choice of contraceptive method must be determined before discharge. Therefore, midwives play an important role in pre-pregnancy and post-natal contraceptive counseling and care

Postpartum family planning counseling aligns directly with the United Nations Sustainable Development Goals (SDGs) by helping women avoid unwanted or closely spaced pregnancies in the postpartum period, ensuring a minimum of 24 months between pregnancies, and enabling couples to consciously choose birth control methods that align with their reproductive preferences. Specifically, SDG 2 (End Hunger) and SDG 3 (Healthy Individuals) aim to promote exclusive breastfeeding for the first six months and continued breastfeeding with complementary foods until the age of two, thereby reducing maternal mortality and morbidity, preventing infant and child deaths, and ensuring universal access to reproductive health services. Research indicates that effective family planning services can reduce maternal mortality by approximately 30%. As stated in a summary of the results on the effects of family planning on nutrition, "malnutrition, including stunting, low weight, weakness, and vitamin deficiencies, contributes to almost half of all childhood deaths. This means that approximately 3.1 million children under the age of 5 die each year from malnutrition-related causes.

In addition, postpartum family planning contributes to SDG 5 (Gender Equality) by supporting women's right to make decisions about their fertility. Furthermore, planning and regulating the intervals between pregnancies aligns with SDG 1 (Poverty Reduction) by easing the economic burden on families, SDG 4 (Quality Education) by supporting girls' education through the prevention of early and unplanned pregnancies, and SDG 8 (Decent Work and Economic Growth) by increasing women's participation in the workforce. Therefore, postpartum family planning counseling is not only It plays a strategic role not only in terms of maternal and child health, but also in terms of social development, gender equality, and economic sustainability.