Evidence for Policy and Practice Information and Coordinating Centre, Social Science Research Unit, Institute of Education, University of London, London.
Contraception. 2013 Jan;87(1):17-25. doi: 10.1016/j.contraception.2012.07.014. Epub 2012 Sep 10.
Unsafe abortion imposes heavy burdens on both individuals and society, particularly in low-income countries, many of which have restrictive abortion laws. Providing family planning counseling and services to women following an abortion has emerged as a key strategy to address this issue.
This systematic review gathered, appraised and synthesized recent research evidence on the effects of postabortion family planning counseling and services on women in low-income countries.
Of the 2965 potentially relevant records that were identified and screened, 15 studies satisfied the inclusion criteria. None provided evidence on the effectiveness of postabortion family planning counseling and services on maternal morbidity and mortality. One controlled study found that, compared to the group of nonbeneficiaries, women who received postabortion family planning counseling and services had significantly fewer unplanned pregnancies and fewer repeat abortions during the 12-month follow-up period. All 15 studies examined contraception-related outcomes. In the seven studies which used a comparative design, there was greater acceptance and/or use of modern contraceptives in women who had received postabortion family planning counseling and services relative to the no-program group.
The current evidence on the use of postabortion family planning counseling and services in low-income countries to address the problem of unsafe abortion is inconclusive. Nevertheless, the increase in acceptance and/or use of contraceptives is encouraging and has the potential to be further explored. Adequate funding to support robust research in this area of reproductive health is urgently needed.
不安全堕胎给个人和社会带来了沉重的负担，特别是在低收入国家，这些国家中有许多国家堕胎法限制严格。为堕胎后的妇女提供计划生育咨询和服务已成为解决这一问题的关键策略。
本系统评价收集、评估和综合了近期关于低收入国家堕胎后计划生育咨询和服务对妇女影响的研究证据。
在确定和筛选的 2965 份潜在相关记录中，有 15 项研究符合纳入标准。没有一项研究提供了关于堕胎后计划生育咨询和服务对产妇发病率和死亡率的有效性的证据。一项对照研究发现，与非受益者相比，接受堕胎后计划生育咨询和服务的妇女在 12 个月的随访期间，意外怀孕和重复堕胎的次数明显减少。所有 15 项研究都检查了与避孕相关的结果。在使用比较设计的七项研究中，与无方案组相比，接受堕胎后计划生育咨询和服务的妇女对现代避孕药具的接受程度和/或使用率更高。
目前关于在低收入国家使用堕胎后计划生育咨询和服务来解决不安全堕胎问题的证据尚无定论。尽管如此，接受和/或使用避孕药具的人数增加令人鼓舞，并有可能进一步探索。迫切需要为生殖健康这一领域的有力研究提供充足的资金支持。
