Voluntary Contraceptive Uptake Among Postabortion Care Clients Treated With Misoprostol in Rwanda

Abstract

Voluntary contraceptive uptake among postabortion care clients treated with misoprostol in Rwanda was high and unhindered by the extended bleeding that sometimes occurs with misoprostol use. However, provider knowledge regarding return to fertility and contraceptive methods appropriate for postabortion care clients should be strengthened.

Postabortion Care and the Voluntary Family Planning Component: Expanding Contraceptive Choices and Service Options

“…The authors describe progress in providing a broad range of family planning methods, including long-acting reversible contraceptives (LARCs); highlight new technologies for communication; document the perspectives of patients and providers, including their views on what is still needed to optimize PAC services; and identify cost-effective strategies for governments, programs, and donors 10 – 14 …”

“…The authors also document that misunderstanding and misconceptions about contraceptives remain a major stumbling block in providing the family planning component of PAC to clients; that training in counseling and values clarification is much needed; and that engaging men to support family planning for their partners is important and can be challenging 6 – 10 , 12 , 14 – 16 …”

“…This need was noted by providers, patients, and program managers 7 – 9 , 14 , 15 Establishing a contraceptive logistics system to ensure a full range of contraceptive options at every site providing PAC.Recognizing cost as a major barrier for many women and recommending that PAC services, especially a wide range of contraceptive options, be available for free or at minimal cost 6 , 7 , 9 , 10 , 12 , 15 , 16 Decentralizing PAC services to lower-level facilities and expanding the scope of practice for midlevel providers, especially nurses and midwives, to include PAC 6 , 8 , 9 , 11 , 13 – 15 …”

“…Decentralizing PAC services to lower-level facilities and expanding the scope of practice for midlevel providers, especially nurses and midwives, to include PAC 6 , 8 , 9 , 11 , 13 – 15 Discussing with women their reproductive intentions, rapid return of fertility, potential complications after treatment, and if a contraceptive is desired, essential information about the woman’s chosen contraceptive method 6 , 8 , 10 – 14 , 16 . To supplement counseling on these key points, health professionals call for providing women with user-friendly written information, which also provides a job aid for providers 2 – 5 .…”

“…Recognizing cost as a major barrier for many women and recommending that PAC services, especially a wide range of contraceptive options, be available for free or at minimal cost 6 , 7 , 9 , 10 , 12 , 15 , 16 …”