**5. Trends in contraceptive use**

According to the WHO, postpartum family planning (PPFP) is defined as the prevention of unintended pregnancy and closely spaced pregnancies through the first 12 months following childbirth [23]. The proper practice of contraceptives during the postpartum period has its impact on prolonging interpregnancy interval and indirectly reduces postpartum complications and other consequences [24]. Therefore, contraceptives help in the prevention of unwanted pregnancies among couples and, therefore, promote planned family size and time of birth for improved reproductive well-being of the women. Voluntary family planning practices include the promotion of maternal and child health, human rights, population and development, and environmental sustainability and development of a nation. However, the use of contraceptives was found with marked variation between developed and developing nations, across nations, and within nations. Despite the United Nations (2015) report on the trend of contraceptive use among women of the reproductive age group, who are either married or in a union, in almost all regions of the world reached up to 64% [23]. At the end of the millennium development goals, the United Nations report showed that contraceptive use was much lower in the least developed countries with an estimate of 40.0% with the African continent had the lowest estimated at 33.0% [24]. In Nigeria for example, only 14.5% of women use modern contraceptive methods according to the estimation from the national population commission [25]. Moreover, over 83% of women were not using any form of contraceptives in 2018 with a geographical variation within the country [26]. Regional averages hide some of the more dramatic variations in contraceptive sources at the country level [27]. More than half of women in low- and middleincome countries using modern contraception go to private sector sources than public sources [28].

The sustainable development goals (SDGs) target 3.7 calls on all countries "by 2030 to ensure universal access to sexual and reproductive health-care services, including for family planning, information and education, and the integration of reproductive health into national strategies and programs" [29]. The assessment of progress toward this target requires monitoring of key family planning indicators, including the range and types of contraceptive methods used [27]. There are several barriers to using effective methods in low- and middle-income countries including the desire for more children, partner disapproval of contraceptive use, religious and cultural bias, educational qualification of women, lack of knowledge on contraceptives, and wealth index [30]. Additional factors reported, such as concerns about the side effects of contraceptive methods, women's or their family's opposition to contraception, lack of access to supplies and services, and especially financial barriers, are often reported [31]. Consequently, a trend of high family sizes of up to seven or above is common in many regions of low- and middleincome countries.

*Perspective Chapter: Contemporary Challenges in Postnatal Care in Low- and Middle-Income… DOI: http://dx.doi.org/10.5772/intechopen.111446*
