Sabu S Padmadas1, Mark Lyons-Amos2, Shyam Thapa3. 1. Department of Social Statistics and Demography, Faculty of Social and Human Sciences, University of Southampton, Southampton, UK; Centre for Global Health, Population, Poverty and Policy, Faculty of Social and Human Sciences, University of Southampton, Southampton, UK. Electronic address: s.padmadas@soton.ac.uk. 2. ESRC Centre for Population Change, University of Southampton, Southampton, UK; Department of Quantitative Social Science, Institute of Education, University of London, London, UK. 3. Nepal Public Health Foundation, Kathmandu, Nepal.
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 were educated, wealthier, had used contraceptives before the index pregnancy, had two sons and had autonomy initiated contraceptive use significantly earlier in the post-abortion period than their counterparts. 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.
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 were educated, wealthier, had used contraceptives before the index pregnancy, had two sons and had autonomy initiated contraceptive use significantly earlier in the post-abortion period than their counterparts. 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.
Authors: Mandira Paul; Sharad D Iyengar; Birgitta Essén; Kristina Gemzell-Danielsson; Kirti Iyengar; Johan Bring; Marie Klingberg-Allvin Journal: BMC Public Health Date: 2016-10-17 Impact factor: 3.295
Authors: Martin M Rwabilimbo; Bilikisu R Elewonibi; Mashavu H Yussuf; Masanja Robert; Sia E Msuya; Michael J Mahande Journal: PLoS One Date: 2021-03-25 Impact factor: 3.240