Postabortion contraception

New study points to ‘tremendous opportunity’ to improve uptake

Many women seeking abortion care leave health facilities without getting contraceptive counseling or a method choice, increasing their risk of future unintended pregnancy. A new, large-scale study by Ipas finds that offering women contraceptive counseling and a choice of methods at the time of abortion can significantly improve contraceptive uptake, even in settings where contraceptive prevalence is low.

The study, recently published in the journal Global Public Health, analyzed contraceptive uptake among 319,385 women seeking abortion in eight countries: Bangladesh, Ethiopia, Ghana, India, Nepal, Nigeria, South Africa and Zambia. It is among the first to document such large-scale results from postabortion contraception interventions. Ipas Vice President Janie Benson, who directs Ipas’s research and evaluation program and is first author of the study, says the findings underscore a “tremendous opportunity” to reduce the unmet need for contraception, reduce unintended pregnancy and decrease unsafe abortion.

Ipas assessed 2,326 health facilities, 319,385 abortion services, in eight countries and found:

Distinct variations between abortion clients in Africa and Asia

In Africa, women were younger, more likely to present for postabortion care (PAC), more likely to present in the second trimester of pregnancy, and more likely to receive medical abortion rather than vacuum aspiration.

High postabortion contraceptive update

High uptake among abortion clients occurred even in countries with low national modern contraceptive prevalence for married women.

Contraceptive method mix among acceptors

Contraceptive uptake varies by:

Programmatic interventions

During the period of analysis, Ipas provided technical assistance to Ministries of Health and service providers in the eight countries on programs designed to increase women’s access to postabortion contraception.

Interventions included updating national service guidelines; training providers, both on clinical skills and on counseling clients for informed choice; making contraceptive methods available where abortion services were provided; and updating processes for service statistics. In some settings, there was community outreach to inform women about contraceptive and abortion care.

“Integrating contraceptive counseling and provision into the abortion visit helps women prevent unintended pregnancies and contributes to their reproductive health.”

Download the full study. Find out more about Ipas research.

For more information, contact media@ipas.org

Stay informed and inspired with updates on how we’re working globally to improve access to safe abortion and contraception. Learn more