Peri-abortion contraceptive care: Can we reduce the incidence of repeat abortions (original) (raw)
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Counseling Prior Contraception: Is It a Provider Failure or Patient Failure?
Unintended pregnancy is not only a major health problem, but are also a great social and financial burden on societies and countries. There are about 75 million unwanted pregnancies per year according to WHO statistics. When abortions were included, unintended pregnancies increased to 2.65 million, or 49% of all pregnancies. Counseling prior contraception is a mandatory or a must to prevent these unintended pregnancies and their related risks. Unfortunately counseling is a deficient process in third world countries and usually made by young medical staffs or sometimes by paramedical personnel or not present at all. In this perspective, issues for deficient counseling and how patients select the method of contraception are addressed.
The effectiveness of preabortion contraception counseling
International Journal of Gynecology & Obstetrics, 2001
Objecti¨e: To demonstrate the impact of preabortion counseling followed by immediate postabortal provision of the chosen method on postabortion contraceptive use. Methods: Three hundred and forty-two women undergoing voluntary termination of pregnancy at less than 10 weeks gestation were enrolled at the Woman and Child Health Training and Research Clinic, Medical School of Istanbul. Clinic visits and telephone surveys were performed to measure contraceptive use at 6 months following abortion. Result: Two hundred and thirty-six women either visited the clinic or responded to the telephone survey. Eighty percent of the respondents reported use of a modern contraceptive as compared to less than 40% prevalence found in the national survey. Conclusion: Preabortion counseling combined with immediate postabortal provision of contraceptives may significantly increase contraceptive use at 6 months postprocedure. ᮊ
Contraceptive Continuation, Pregnancy and Abortion Rate Two Years after Post Abortion Counselling
Open Journal of Obstetrics and Gynecology, 2015
Objectives: To estimate the contraceptive use rate, pregnancy and abortion rate two years after post abortion counselling. Methods: In this current paper we conducted a cross-sectional study from September to December 2011 among women who participated of original randomized trial. In this study 118 women who had been allocated in the group that received the personalized contraceptive counselling and 103 women who had been allocated in the group that received standard counselling service were contacted by phone. The analyzed variables were the use of contraceptive methods, reasons for not using them, satisfaction in used method, and occurrence of pregnancy and abortion. Results: The pregnancy rate was lower in the personalized counselling group (p = 0.022), whereas abortion (p = 0.543) and contraceptive use rate (p = 0.270) had no difference between groups. The overall contraceptive use rate was high in both groups and the injectable method use rate was higher in personalized counselling group (p = 0.004). Conclusions: Two years after the intervention the pregnancy rate was lower in personalized counselling group. The contraceptive use rate had no difference between the groups, except for the injectable which the use rate was higher in the personalized counselling group. These results could be encouraging because the intervention improved the uptake of one of the long-acting methods of contraception.
Contraceptive practice before and after termination of pregnancy: a prospective study
Contraception, 2003
This study is part of a larger prospective research program focusing on termination of pregnancy (TOP). One hundred and three women requesting TOP were interviewed before the intervention and 6 months later using open and closed questions and psychological tests. This paper focuses on contraceptive practices before and after abortion. The analysis took into account specific aspects of contraceptive practices and patients' behaviors. The aims were to assess: the level of women's knowledge and practice of contraception at the time of request for a TOP; the behavioral modifications following professional counseling 6 months after TOP; the influence of psychological and sexual factors, and those linked to the women's use of contraception. Most women (n ϭ 101) had already used recommended contraception. During the cycle that had resulted in pregnancy, more than half (n ϭ 58) had used recommended contraception and one third had not used any contraception. Six months later, 86 women used recommended contraception, and 17 did not. The majority of women reported changes in their contraceptive methods (n ϭ 82). Most changes were within recommended methods. The women (n ϭ 10) who continued to practice unprotected intercourse post-TOP were slightly older, satisfied with their sexual relations with their partner, often involved in a long-term and good relationship. During post-TOP period, it is essential to take into account the psychological dynamics involved in the choice of contraceptive methods. Counseling should emphasize not only protection against an unwanted pregnancy but also protection against sexually transmitted diseases, which is often perceived as a less important issue following TOP.
Impact of Post Abortal Counselling and Acceptability of Concurrent Contraception
Background: Throughout developing world there is a large gap between people desire to space and their use of contraception (UNMET NEED) and this end up in unwanted pregnancy. In India 20 % of pregnancies are unwanted and more than half undergo unsafe abortion contributing to 8% of maternal death. 'You cannot die from a pregnancy you don't have'. India being the second populous, to combat unmet need is a national emergency, and post abortal counselling is an effective tool. Aim: This prospective observational study was conducted to assess the impact of post abortal contraception counselling and to determine the acceptability of concurrent contraception. Material and Method: All 258 women who had abortion and who had been provided post abortion counselling between October 2007 and September 2009 were the main source of study. The women were enquired about any contraception use and compliance, before abortion. Following post abortion counselling, the number of women who accepted to use contraception in the immediate post abortal period were determined. Women who accepted concurrent contraception were followed up by phone call 5months later, with emphasis on practices towards contraception and perseverance. Statistical data: Calculated by simple percentage, p value, odds ratio. Result: Following post abortal counselling the contraceptive acceptance increased remarkably by 74.2% and use of modern method increased by 2 fold (79.5% compared to 29.2 % prior counselling). Extended follow up after 5 months showed that women persevered with contraceptive usage when it was initiated in the immediate in the post abortal period (p 0.0). 10.3 % discontinued in the interval period. Besides increase awareness in multiparous (76%), unplanned pregnancy was high (76.48%) due to poor compliance (41.76%) and the rest of patients discontinued due to fear of side effects and myth about contraception. In my study education and socioeconomic class did not significantly affect the acceptability of contraception (p 0.239, p 0.730). Conclusion: Women having had an unplanned pregnancy and abortion is anxious to avoid repeating it again and also more receptive. Hence post abortion period is an opportune time for health professionals to have a major impact on reproductive health outcomes.
Post-abortion contraception: care and practices
Revista Latino-Americana de Enfermagem, 2014
OBJECTIVE: to analyze assistance regarding contraception methods received by women during hospitalization due to abortion, and contraceptive practices the month after this episode.METHODS: a longitudinal study of women hospitalized due to abortion in a public hospital in the city of São Paulo. Face-to-face interviews (n=170) followed by telephone interviews in the subsequent month (n=147) were conducted between May and December of 2011.RESULTS: a small number of women reported they received guidance on, and prescription for, contraceptive methods at hospital discharge. A trend of statistical significance was identified for prescription of contraceptive methods at discharge and its use in the following month, when adjusted for age. Most women reported sexual intercourse (69.4%) with the use of contraceptive method (82.4%), but no health professional guidance (63.1%).CONCLUSION: despite the fact that post-abortion contraception assistance was lower than the recommended guidelines by p...
International journal of scientific research, 2020
OBJECTIVE :- To assess the knowledge, attitude and practices about contraception among women seeking induced abortion. Material & Methods: This is a cross sectional study conducted in Dept.of OBGY,GMCH, Aurangabad between the period October 2019 to March 2020 using predesigned pretested questionnaire in women seeking medical termination of pregnancy. Observation:-Around 90% women were aware about contraception. Knowledge regarding tubectomy was more (77.66%) than other methods of contraception. Around 60% women were willing to use contraception and 70% women accepted contraception after counselling at the time of availing abortion services. Conclusion: Overall awareness of contraception was about 90%. Overall acceptance of contraception was 70% and utilization of tubectomy, as a permanent method of contraception was high due to government initiatives and incentives . Fear of side effects of contraception was an important factor for contraception denial . Husband’s support in the cho...
Contraception counselling during gynecology visit — does a questionnaire help?
Ginekologia Polska, 2020
Objectives: Women are at risk of unplanned pregnancy and inappropriate choice of contraception if not given effective contraception counselling. We aimed to understand the contraceptive needs of women, improve effective contraception counselling promoting modern contraception methods during gynecology outpatient visit using a contraception counselling questionnaire. Material and methods: All reproductive-age women over 18 were given Contraception Counselling Project Form to fill in while in the waiting room. The form consisted of 15 questions evaluating patients' characteristics and contraceptive method used. Physicians evaluated these forms during the examination and an appropriate method was chosen. Forms of pregnant, postmenopausal and sexually inactive patients as well as forms with more than one answer missing were excluded. Results: 778 questionnaires were accepted for evaluation. 340 women (43.8%) used modern contraception, 112 (14.4%) used interrupted coitus, 3 (0.4%) used calendar method. 738 women could be given adequate contraception counselling by the physicians. 215 women among 323 women (66.5%) who did not use modern contraception and did not desire pregnancy, were convinced to use modern contraception and 103 (91.9%) among 112 women who used interrupted coitus for contraception were convinced to use modern contraception. There was a significant relationship between age, education, working state, parity, number and type of delivery, previous OCP usage, resources of contraception and the preferred contraception method. Conclusions: More than half the women preferred to use modern contraception methods by means of contraception counselling questionnaire. Women's backgrounds significantly affected their choice of contraception method.