New study in Kenya shows how pharmacies can boost postabortion contraception

Study

Demand for Contraception after Self -Managed Medical Abortion: The Case of Nakuru County, Kenya

Published in International Journal of Business and Social Science

Conducted using data from 401 women receiving abortion with pills at 21 Ipas-supported pharmacies in Nakuru County, Kenya, this study  examines what drives contraceptive use after self-managed abortion with pills and shows what missed opportunities persist.

Pictured above: Pharmacists partnering with Ipas for medical abortion self-use and post abortion contraception service delivery in Kenya. © Ipas Africa Alliance

Main takeaway

Women who received contraception at the same time as abortion pills—using a “bundled” approach where both services were offered together—were 49% more likely to continue use of contraception afterwards. In contrast, those merely exposed to generic contraceptive promotion at the time of abortion were significantly less likely to adopt a method on their own. The study also found that postabortion contraceptive use is strongly shaped by women’s age, education, prior contraceptive experience, and the support of their partners and peers in the decision to choose abortion.

This illustrates that to increase postabortion contraceptive use through pharmacies, the offer must be well-timed and matched to what women want and need at that moment.

Why it matters

Postabortion contraception is essential for preventing unintended pregnancies, especially in low-resource areas where access to reproductive health services is limited or inconsistent. In these settings, community pharmacies often serve as the most accessible point of care, particularly for people who can’t reach hospitals or clinics. This makes them a critical part of bringing essential care to people in their own neighborhoods, where traditional health systems don’t always reach.

However, simply promoting contraception with generic messaging at pharmacies isn’t enough. This study shows that when contraception is bundled directly with abortion pills, uptake increases significantly. Investing in pharmacy-based services that are person-centered and conveniently offered at the same time as abortion with pills, could dramatically improve contraceptive use and reduce unintended pregnancies.

Key findings

• Bundling works when guided by women’s immediate needs: Women who received contraception with abortion pills were 49% more likely to use a contraceptive method afterward.
• Timing and counseling gaps matter: Exposure to only generic contraceptive promotion at the time of abortion was associated with a 26% lower likelihood of using postabortion contraception, likely due to poor alignment with clients’ counseling and timing needs.
• Partner and peer support helps: Women who had social support when deciding to end a pregnancy were 17% more likely to use contraception afterward.
• Prior contraceptive use influences future behavior: Women who had used contraception before were 13% more likely to adopt a method again post-abortion.

Noteworthy

This study is one of the first in Kenya to quantify how pharmacy-based abortion clients navigate postabortion contraceptive decisions and what influences them. It confirms that community pharmacies are a promising but underutilized channel for expanding access to contraceptive counseling and postabortion uptake.