Table 7.

Changes in service provision in regards to family planning following survey

Target	Change in service provision
Midwife training points	Benefits of LAC
	Health consequences of choosing methods with a higher risk of failure Risks of pregnancy in women over 35 years of age
	Sensitive counseling in women with a history of a child death
	Identify and address fears surrounding sterilization
	Clarify the word operation: take time to distinguish the small 1–2 cm wound of a female sterilization from others such as cesarean section
	Explanation of recovery time after a sterilization
	Use of the diagram with every one-on-one counseling
	Provision of contraception before discharge
	Benefit and importance of counseling women about tubal resection before cesarean section
Antenatal care counseling for women	FP counseling increased: more frequent and earlier messaging with encouragement to discuss the family size with the husband
	At 22 weeks all P ≥ 1 discuss the option of sterilization in the event of unexpected cesarean section
	At 22 weeks all P ≥ 1 discuss the option of sterilization/IUD and implant
Postnatal care counseling for women	If FP cannot be provided before discharge then follow-up and engagement at the first post-partum visit is required
Inclusion of men	Women are encouraged to bring their husbands to come to the clinic and discuss the family size, medical and obstetric problems
	Couple counseling particularly encouraged in parity >3 with the highest chance to provide this in the post-partum period

Abbreviations: LAC long acting contraception