ICSSR Post Doctoral Fellow, G. B. Pant Social Science Institute, Prayagraj, India. Correspondence:
Program Officer, Population Council, New Delhi, India.
Sex Reprod Health Matters. 2021;29(2):1966983. doi: 10.1080/26410397.2021.1966983.
The unmet need for contraception is documented as a significant determinant of unintended pregnancies and high number of induced abortions. The period immediately after an abortion is recognised as a unique opportunity to offer contraceptive services. This paper explores the association between place of abortion and women's post-abortion contraceptive behaviour. The reproductive calendar data from the National Family Health Survey (NFHS-4) (2015-16) was used for this study. Multinomial logistic regression models were used to understand factors associated with post-abortion method choices. Single decrement life-tables were built to examine rates of contraceptive discontinuation and proportional hazard models were employed to examine probability and correlates of method discontinuation. About 20% of women who underwent an abortion adopted a contraceptive method by the end of one month following an abortion. The decision to choose methods like sterilisation or intrauterine contraceptive devices (IUCDs) was associated with the place of abortion, past contraceptive behaviour, number and sex of surviving children at the time of abortion, mass media exposure, and time of the abortion. Compared to women who underwent an abortion at private health facilities, women who sought abortion at public health facilities were more likely to choose permanent methods or IUCDs. Furthermore, women who opted for an IUCD were less likely to discontinue the method compared to those using short-acting modern methods. The lack of post-abortion contraceptive choices for women is evident in the low uptake of post-abortion contraceptives in private facilities and the predominant promotion of permanent methods and IUCDs in public health facilities.
避孕需求未得到满足被认为是导致意外怀孕和大量人工流产的一个重要决定因素。人工流产后立即被认为是提供避孕服务的独特机会。本文探讨了人工流产地点与妇女流产后避孕行为之间的关联。本研究使用了国家家庭健康调查（NFHS-4）（2015-16 年）的生育日历数据。使用多项逻辑回归模型来了解与流产后方法选择相关的因素。构建单递减生命表来检查避孕方法的停用率，并使用比例风险模型来检查方法停用的概率和相关因素。大约 20%的人工流产妇女在流产后一个月内采用了避孕方法。选择绝育或宫内节育器（IUD）等方法的决定与人工流产地点、过去的避孕行为、流产时存活子女的数量和性别、大众媒体接触以及流产时间有关。与在私立卫生机构进行人工流产的妇女相比，在公立卫生机构进行人工流产的妇女更有可能选择永久性方法或 IUD。此外，选择 IUD 的妇女与使用短效现代方法的妇女相比，更不可能停止使用该方法。在私立机构中，流产后避孕措施的采用率较低，而在公立卫生机构中，主要推广永久性方法和 IUD，这表明妇女的流产后避孕选择不足。
