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Background Several risk factors contributing to pregnancy outcomes among young women have been witnessed. It is well established that contraception plays a foremost role in reducing maternal mortality, obviously linked to pregnancy outcomes. Little is known about the impact of contraception uptake on pregnancy outcomes in the Indian context. Thus, this paper aimed to examine the effect of type of contraception on pregnancy outcomes among young married women aged 15–24 years. Methods Data was extracted from the 2015-16 and 2019-21 National Family Health Survey (NFHS). The main outcome measure was pregnancy outcomes (live birth, abortion, miscarriage and stillbirth). Type of contraception uptake (no contraception, Short-Acting Reversible Contraceptives (SARCs), Long-Acting Reversible Contraceptives (LARCs) and permanent methods) was considered as the key exposure variable. To fulfil the study objective, cross-tabulations, chi-squared tests, and multinomial logistic regression models were employed. Results During 2015-16–2019-21, the prevalence of live birth declined by 5.74%, whereas the proportion of miscarriage, abortion and stillbirth increased by 4.87%, 0.79% and 0.06%, respectively. Results from the multinomial models revealed that the association between type of contraception and pregnancy outcomes were strongly significant, even after adjusting for many other potential correlates. The results further found that the likelihood of abortion, miscarriage and stillbirth were significantly lower among young women using SARCs and markedly lower among women using LARCs methods, compared to no contraception use. Besides, women’s age group, body mass index, height, haemoglobin level, parity, antenatal visits, place and mode of delivery, desire for more children, pregnancy intentions, distance to a nearest health facility, education level, social group, wealth quintile place and region of residence were also significantly associated with pregnancy outcomes. Conclusions The findings from this paper reinforced the need of the hour for implementing effective policies and adverse pregnancy prevention strategies towards ensuring access to the most effective contraception and underscore the importance of scaling up the quality of family planning services and health education that could lead to achieving the best possible pregnancy outcomes among young women.

The adoption of maternity services and postpartum modern contraception are the two most crucial components that help in reducing maternal and infant mortality; still, India is consistently struggling with it. This paper, therefore, aimed to examine the linkages between use of maternity services and postpartum modern contraceptive adoption. The required reproductive calendar data were extracted from the 2015-16 and 2019-21 National Family Health Survey (NFHS) datasets. The assessment was made based on a sample of currently married women aged 15-24 years who had given most recent childbirth in five years preceding the survey. For the analysis, a time-to-event approach was applied using the Kaplan-Meier survival statistic, Log-Rank Chi-square test and Cox-Proportional Hazard (Cox-PH) models. The results revealed that the proportion of postpartum modern contraceptive uptake among young users increased by 9%, from 33% in 2015-16 to 42% in 2019-21. The Cox-PH models revealed that, in both NFHS waves, the associations between various components of maternity services and postpartum modern contraceptive uptake were strongly significant, even after controlling for selected socio-economic and demographic correlates. The findings of this study reinforced urgent need for implementing integrated maternal-child health and family planning programmes and for boosting effective family planning counselling by health professionals to promote and motivate young women with a desire to early adoption of modern contraception in subsequent months after a recent childbirth.

Background Unintended pregnancy and short Interpregnancy Interval (IPI) are believed to have detrimental effects on child survival. To reduce infant mortality through improved Family Planning (FP), a better understanding of factors driving pregnancy intention, IPI and postpartum contraception uptake and how this decision affects infant survival is needed. Thus, this paper aimed to examine the effects of pregnancy intention, IPI and postpartum contraception uptake on infant mortality in India. Methods Data were drawn from the 2015-16 and 2019-21 National Family Health Survey (NFHS). The main outcome measure was infant mortality. The key exposure variables were pregnancy intention, IPI and postpartum contraception uptake. To fulfil the study objective, a time-to-event approach was applied to the analysis using the Kaplan-Meier survival function, Log-Rank Chi-square test and Cox-Proportional Hazard (Cox-PH) model. Results The results showed that the proportion of infants WHO died during the first year after birth declined by only 0.4%, from 3.8% in 2015-16 and 3.4% in 2019-21. The Cox-PH models revealed strongly significant associations between pregnancy intention, IPI, and postpartum contraception uptake with infant mortality in both NFHS rounds, even after controlling for socio-economic, demographic and program-related factors. Besides, mother’s age at last birth, parity, antenatal visits, place and mode of delivery, postnatal check-up, breastfeeding, distance to nearest health facility, media exposure, level of education, religion, caste, wealth index, place and region of residence emerged as significant factors associated with infant mortality. Conclusion The findings of this paper reinforced an inescapable need for implementing effective programmatic interventions for the quality of FP counselling and monitoring to enhance postpartum modern contraception uptake as a way of helping young women to avert unintended pregnancy and achieve optimal IPI that would eventually lead to improving child survival among infants in India.