Associations Between Abortion Services and Acceptance of Postabortion Contraception in Six Indian States

Gulati, Sumit; Andersen, Kathryn; Acre, Valerie; Warvadekar, Janardan; Navin, Deepa

doi:10.1111/j.1728-4465.2015.00039.x

Cited by 24 publications

(29 citation statements)

References 26 publications

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“…In addition, specialist service providers play a relatively important role in the adoption of highly effective contraception [16]. The adoption of long-acting reversible and permanent contraceptive methods is dependent on the service provider’s capacity to offer these methods during PAC [34].…”

Section: Discussionmentioning

confidence: 99%

Spatial and socio-economic correlates of effective contraception among women seeking post-abortion care in healthcare facilities in Kenya

et al. 2019

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Introduction Information, counseling, availability of contraceptives, and their adoption by post-abortion care (PAC) patients are central to the quality of PAC in healthcare facilities. Effective contraceptive adoption by these patients reduces the risks of unintended pregnancy and repeat abortion. Methods This study uses data from the Incidence and Magnitude of Unsafe Abortion Study of 2012 to assess the level and determinants of highly effective contraception among patients treated with complications from an unsafe abortion in healthcare facilities in Kenya. Highly effective contraception was defined as any method adopted by a PAC patient that reduces pregnancy rate by over 99%. Results Generally, contraceptive counseling was high among all PAC patients (90%). However, only 54% of them received a modern family planning method—45% a short-acting method and 9% a long-acting and permanent method. Adoption of highly effective contraception was determined by patient’s previous exposure to unintended pregnancies, induced abortion and modern family planning (FP). Facility level factors associated with the uptake of highly effective contraceptives included: facility ownership, availability of evacuation procedure room, whether the facility had a specialized obstetric-gynecologist, a facility that also had maternity services and the number of FP methods available for PAC patients. Discussion and conclusion For better adoption of highly effective FP, counseling of PAC patients requires an understanding of the patient’s past experience with contraception and their future fertility intentions and desires in order to meet their reproductive needs more specifically. Family planning integration with PAC can increase contraceptive uptake and improve the reproductive health of post-abortion care patients.

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Section: Discussionmentioning

confidence: 99%

Spatial and socio-economic correlates of effective contraception among women seeking post-abortion care in healthcare facilities in Kenya

et al. 2019

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“…Hospital environments present special challenges for postabortion contraception, with several studies reporting that women obtaining abortion care in hospitals are less likely to receive any contraception than those in primary health centers or clinics. 18 , 25 A variety of factors likely contribute to this finding, including the multiple health care workers attending a single client in a hospital, logistical difficulties in ensuring that contraceptive commodities are routinely available in the abortion treatment area, the perception that contraceptive provision is not a physician's task, provider workloads that prioritize more acute care, and administrative barriers to linking 2 different services. With their lower uptake of contraception, clients seeking abortion at 13 weeks or greater gestation therefore represent a group at risk of subsequent unintended pregnancy.…”

Section: Discussionmentioning

confidence: 99%

“…Differences in contraceptive uptake by abortion technology have also been found in other studies using monitoring data from Ipas-supported facilities, with similar or higher acceptance of any contraceptive method with medical abortion compared with MVA/EVA but lower LARC uptake. 18 , 25 Women receiving induced abortion and contraception in Indian NGO clinics found that acceptance of any method was similar for MVA and medical abortion clients within 2 months following services, although method mix varied. Women who had an MVA were more likely to have had an IUD or sterilization, while medical abortion clients mainly chose IUDs and condoms.…”

Section: Discussionmentioning

confidence: 99%

What Factors Contribute to Postabortion Contraceptive Uptake By Young Women? A Program Evaluation in 10 Countries in Asia and sub-Saharan Africa

Benson¹,

Andersen²,

Healy³

et al. 2017

Glob Health Sci Pract

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“…Thus, although some women who had a medical TOP may have experienced logistical barriers to choosing an IUC, others may simply be less likely to desire one, perhaps because of the requirement for provider-dependent placement, perceptions of placement as surgery, or a greater comfort level with taking oral contraceptives. Alternatively, women who desire an IUC may choose surgical TOP in order to obtain one immediately following the procedure; however, although other national and international studies have also found higher IUC uptake after surgical as opposed to medical TOP, 22,[31][32][33] none has examined this particular possibility.…”

Section: Discussionmentioning

confidence: 99%

Contraceptive method preferences and provision after termination of pregnancy: a population‐based analysis of women obtaining care with the British Pregnancy Advisory Service

Aiken

Lohr²,

Aiken

et al. 2016

BJOG

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Objective To examine contraceptive choices among women seeking termination of pregnancy (TOP) and the provision of the chosen methods. Design Population-based study. Setting British Pregnancy Advisory Service (BPAS) clinics in England and Wales. Population Between 1 January 2011 and 31 December 2014, 211 215 women had a TOP at BPAS, were offered contraceptive counselling, and were eligible to obtain contraception at no cost. Methods We examined electronic records from BPAS and assessed the proportions of women who accepted contraceptive counselling and chose a contraceptive method, as well as the distributions of methods chosen, analysed by provider and by TOP type. We calculated the proportions receiving their chosen method and the methods chosen by women using no method at conception. We used logistic regression to examine the factors associated with choice of an intrauterine contraceptive (IUC) or implant. Main outcome measures Post-TOP contraceptive method choice. Receipt of chosen method post-TOP. Results Eighty-five per cent of women accepted contraceptive counselling and chose to obtain a method from BPAS rather than from a GP or contraception and sexual health clinic post-TOP. Among those who wanted to receive contraception from BPAS, 51% chose an IUC or implant and 19% chose oral contraceptives. Ninety-one per cent of women who obtained contraception from BPAS received their chosen method. Women were more likely to choose an IUC or implant if they obtained contraception from BPAS, had a surgical TOP, were parous, young, white, or had one or more previous TOPs. Conclusions The standards set for patient-centred TOP care should emphasise the need for a full range of contraceptive options to be offered and provided post-TOP.

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Associations Between Abortion Services and Acceptance of Postabortion Contraception in Six Indian States

Cited by 24 publications

References 26 publications

Spatial and socio-economic correlates of effective contraception among women seeking post-abortion care in healthcare facilities in Kenya

Spatial and socio-economic correlates of effective contraception among women seeking post-abortion care in healthcare facilities in Kenya

What Factors Contribute to Postabortion Contraceptive Uptake By Young Women? A Program Evaluation in 10 Countries in Asia and sub-Saharan Africa

Contraceptive method preferences and provision after termination of pregnancy: a population‐based analysis of women obtaining care with the British Pregnancy Advisory Service

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