Huber-Krum S, Hackett K, Senderowicz L, et al. Women's Perspectives on Postpartum Intrauterine Devices in Tanzania. Studies in Family Planning. 2019;50 (4). Publisher's Version
Senderowicz L. "I was obligated to accept": A qualitative exploration of contraceptive coercion. Social Science and Medicine. 2019;239C (112531). Publisher's Version
Senderowicz L, Sanhueza P, Langer A. Education, Place of Residence and Utilization of Legal Abortion Services in Mexico City from 2013-2015. International Perspectives on Sexual and Reproductive Health. 2018;44 (2) :43-50. Publisher's Version
Soura A, Lankoande B, Sanogo S, Compaore Y, Senderowicz L. Understanding premarital pregnancies among adolescents and young women in Ouagadougou, Burkina Faso. Cogent Social Sciences . 2018;4 (1) :1-18.
Canning D, Shah IH, Pearson E, et al. Institutionalizing postpartum intrauterine device (IUD) services in Sri Lanka, Tanzania, and Nepal: study protocol for a cluster-randomized stepped-wedge trial. BMC Pregnancy and Childbirth. 2016;16 (1) :362. Publisher's VersionAbstract


During the year following the birth of a child, 40% of women are estimated to have an unmet need for contraception. The copper IUD provides safe, effective, convenient, and long-term contraceptive protection that does not interfere with breastfeeding during the postpartum period. Postpartum IUD (PPIUD) insertion should be performed by a trained provider in the early postpartum period to reduce expulsion rates and complications, but these services are not widely available. The International Federation of Obstetricians and Gynecologists (FIGO) will implement an intervention that aims to institutionalize PPIUD training as a regular part of the OB/GYN training program and to integrate it as part of the standard practice at the time of delivery in intervention hospitals.


This trial uses a cluster-randomized stepped wedge design to assess the causal effect of the FIGO intervention on the uptake and continued use of PPIUD and of the effect on subsequent pregnancy and birth. This trial also seeks to measure institutionalization of PPIUD services in study hospitals and diffusion of these services to other providers and health facilities. This study will also include a nested mixed-methods performance evaluation to describe intervention implementation.


This study will provide critical evidence on the causal effects of hospital-based PPIUD provision on contraceptive choices and reproductive health outcomes, as well as on the feasibility, acceptability and longer run institutional impacts in three low- and middle-income countries.

Trial registration

Trial registered on March 11, 2016 with, NCT02718222.

Rossier C, Senderowicz L, Soura A. Do Natural Methods Count? Underreporting of Natural Contraception in Urban Burkina Faso. Studies in Family Planning. 2014;45 (2) :171-182. Publisher's VersionAbstract

Natural methods of contraception were widely used in developed countries until the late 1960s to space and limit childbirth. In France, when the first contraceptive surveys were conducted, researchers noticed that the use of natural methods was underreported, and questions to correct for this bias were subsequently added. The Demographic and Health Surveys do not currently include questions specific to natural methods. We added such questions to the standard DHS question regarding current contraceptive use when we conducted the Health and Demographic Surveillance System of Ouagadougou (2010 Ouaga HDSS) health survey in Burkina Faso among 758 women aged 15-49. Doing so enabled us to find a notable increase in the proportion of women in union who reported practicing contraception: 58 percent, compared with 38 percent in Ouagadougou in the 2010 Burkina Faso DHS. Thirty-two percent of women reported using modern medical methods or condoms in both surveys, but use of natural methods was much greater in the 2010 Ouaga HDSS health survey (26 percent) than in the 2010 Burkina Faso DHS (5 percent). Many women classified as having unmet need for family planning in Ouagadougou by the DHS data are in fact users of natural methods. Additional questions that would measure use of natural methods more completely should be tested in different settings.