Post abortion contraceptive uptake and continuation rates at Korle-Bu Teaching Hospital, Accra, Ghana

Abstract

Introduction: The tragedy of unsafe abortion is that it is one of the easily preventable causes of maternal death. In Ghana, the maternal mortality ratio was 319/100,000 live births. (WHO, 2015) of which 11% of these were abortion related. 13% of abortions had complications including chronic pelvic pain, offensive discharge and uterine perforation In spite of the above, this study sought to find out factors that affect uptake and continuation rates of post abortion contraception at the Korle Bu Teaching Hospital. Methods: This was a longitudinal study using interviewer administered questionnaire of women reporting for elective termination of pregnancy or for uterine evacuation for incomplete abortion either induced or spontaneous. Participants were followed up by telephone calls at end of 1, 3 and 6 months. Simple proportions was calculated for post-abortion contraception uptake and continuation rates. Multiple logistic regression was used to determine factors associated with uptake and continuation rates. A p-value of less than or equal to 0.05 was considered as statistically significant. Results: The study included 338 participants. The overall uptake was 132 (39.1%). Eighty-seven (25.7%) on discharge and 45 (13.4%) additional uptake within one month of the follow-up. Continuation rate at 6 months was 68.9%. Significantly associated factors were educational level, employment and marital status, gravidity/parity and previous contraceptive use. Conclusion: Post-abortion contraception uptake of 39.1% with 68.9% continuation rate at 6 months found in this study is low. This implies high unmet need for post-abortion contraception that needs to be addressed urgently.