What contraception do women use after experiencing complications from abortion? an analysis of cohort records of 18,688 postabortion care clients in Tanzania

Colin Baynes,J Bantambya,M Hiza,J Kahwa,L Ngosso,F Mwanga,G Lusiola

doi:10.1186/s12905-018-0687-9

Abstract

BackgroundThe family planning component of postabortion care (PAC) is critical, as it helps women to prevent unintended pregnancies and reduce future incidence of life-threatening unsafe abortion. In Tanzania, PAC was recently decentralized from tertiary-level district hospitals to primary health care dispensaries in four regions of the country. This analysis describes interventions used to improve access to high quality PAC services during decentralization; examines results and factors that contribute to PAC clients’ voluntary uptake of contraception; and develops recommendations for improving postabortion contraceptive services.MethodsThis analysis uses service delivery statistics of 18,688 PAC clients compiled from 120 facilities in Tanzania between 2005 and 2014.ResultsThis study suggests that efforts to integrate postabortion family planning into treatment for incomplete abortion contributed to higher postabortion contraceptive uptake (86%). Results indicate that variables associated with significant differences in contraceptive uptake were facility level, age, gestational age at the time of treatment, and uterine evacuation technology used.ConclusionThe experience of expanding PAC services in Tanzania suggests that integrating contraceptive services with treatment for abortion complications can increase family planning use.

Highlights

The family planning component of postabortion care (PAC) is critical, as it helps women to prevent unintended pregnancies and reduce future incidence of life-threatening unsafe abortion
Data came from PAC registers kept in facilities’ evacuation rooms, where providers maintained records of their encounters with clients that presented to these facilities with complications from spontaneous and induced abortion
These sites admitted women experiencing more severe complications from abortion than those of women that were transferred to the evacuation rooms, which had been established during the scale up of PAC

Summary

Introduction

The family planning component of postabortion care (PAC) is critical, as it helps women to prevent unintended pregnancies and reduce future incidence of life-threatening unsafe abortion. 7 million women who had induced abortions received lifesaving treatment for complications from unsafe pregnancy termination This treatment, postabortion care (PAC), is a service package that addresses the emergency treatment and preventive health care needs of women experiencing complications from early pregnancy termination, both spontaneous and induced. Women seeking postabortion emergency care are in need of contraceptive services: These clients are sexually active and at risk for subsequent pregnancy, not currently pregnant, and often highly desirous of avoiding childbearing They are in contact with the health system, are often disinclined to return to the facility for a follow-up visit [5,6,7], and, according to global recommendations, are advised to delay a subsequent pregnancy for at least six months, for optimal health of the woman and her future newborn [8, 9]

Methods

Results

Discussion

Conclusion