Impact of Post Abortal Counselling and Acceptability of Concurrent Contraception

Abstract

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 socio-economic 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. Keywords: Unmet Need, Post abrotal counselling, Concurrent contraception.