Sara Adelman1, Caroline Free2, Chris Smith3. 1. London School of Hygiene and Tropical Medicine. Electronic address: sara.elan.adelman@gmail.com. 2. London School of Hygiene and Tropical Medicine. 3. London School of Hygiene and Tropical Medicine; School of Tropical Medicine and Global Health, Nagasaki University.
Abstract
OBJECTIVE: To evaluate which characteristics collected at the point of abortion are associated with contraceptive use over the extended postabortion period for women in Cambodia. METHODS: The study includes a cohort of 500 women who attended a Marie Stopes International Cambodia clinic for an induced abortion. The primary outcomes are use of effective contraception ≥80% of the time over the 4- and 12-month period postabortion. We conducted a bivariate analysis to assess the association between each characteristic and the outcome, followed by multivariable modeling to identify the strongest predictors of the outcomes. RESULTS: Nearly 44% of the women used contraception for more than 80% of the time during both follow-up periods. Several sociodemographic and reproductive factors were crudely associated with the outcomes. In the multivariable model, prior use of contraception, intention to use postabortion contraception, increased number of children and medical abortion were associated with increased contraceptive use over the year postabortion. Occupation was a predictor at 4 months only, and abortion method was a predictor at 12 months only. CONCLUSIONS: The models were satisfactory in predicting the outcome of contraceptive continuation both at 4 and 12 months. The paper sets out a methodology for modeling these predictors that can help inform more client-centered counseling and services for women. IMPLICATIONS: Factors known when attending a clinic for induced abortion can help inform more targeted and client-centered postabortion family planning counseling and services for women in Cambodia.
OBJECTIVE: To evaluate which characteristics collected at the point of abortion are associated with contraceptive use over the extended postabortion period for women in Cambodia. METHODS: The study includes a cohort of 500 women who attended a Marie Stopes International Cambodia clinic for an induced abortion. The primary outcomes are use of effective contraception ≥80% of the time over the 4- and 12-month period postabortion. We conducted a bivariate analysis to assess the association between each characteristic and the outcome, followed by multivariable modeling to identify the strongest predictors of the outcomes. RESULTS: Nearly 44% of the women used contraception for more than 80% of the time during both follow-up periods. Several sociodemographic and reproductive factors were crudely associated with the outcomes. In the multivariable model, prior use of contraception, intention to use postabortion contraception, increased number of children and medical abortion were associated with increased contraceptive use over the year postabortion. Occupation was a predictor at 4 months only, and abortion method was a predictor at 12 months only. CONCLUSIONS: The models were satisfactory in predicting the outcome of contraceptive continuation both at 4 and 12 months. The paper sets out a methodology for modeling these predictors that can help inform more client-centered counseling and services for women. IMPLICATIONS: Factors known when attending a clinic for induced abortion can help inform more targeted and client-centered postabortion family planning counseling and services for women in Cambodia.