Contraceptive behavior among women after abortion in Nepal

Padmadas, Sabu S., Lyons-Amos, Mark and Thapa, Shyam (2014) Contraceptive behavior among women after abortion in Nepal. International Journal of Gynecology & Obstetrics, 127 (2), 132-137. (doi:10.1016/j.ijgo.2014.05.012). (PMID:25047427)

Abstract

Objective: To investigate the timing of contraceptive use and estimate the discontinuation rates of temporary methods among women after abortion, or a live birth or stillbirth.

Methods: A sample of married women with detailed pregnancy and contraceptive histories was analyzed in a population-based cross-sectional study based on calendar data extracted from the 2011 Nepal Demographic and Health Survey. Kaplan–Meier cumulative and discrete-time hazard models were used to estimate the timing of contraceptive use and discontinuation rates among users of temporary methods.

Results: The final analysis sample included 3190 women. Of 684 women who had had an abortion, 298 (43.6%) had not initiated any contraceptive use in the 12 months afterwards. Women initiated contraceptive use significantly earlier after abortion (hazard ratio [HR] 2.25; 95% CI, 1.96–2.59; P < 0.001). The rate of discontinuation among contraceptive users was significantly higher in the postabortion group (HR 1.32; 95% CI, 1.05–1.65; P < 0.05). Women who had used contraceptives before the index pregnancy, had two sons, were wealthier, were educated, and had autonomy initiated contraceptive use more rapidly.

Conclusion: Postabortion contraceptive use is low in Nepal. Postabortion family-planning counseling and related services should be strengthened with systematic monitoring and follow-up interventions.

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Contributors

Author: Sabu S. Padmadas

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