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Contraceptive uptake among post-abortion care-seeking women with unplanned or planned pregnancy in western Kenya.
Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing. Karolinska Institutet.ORCID iD: 0000-0002-8947-2949
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2020 (English)In: Sexual & Reproductive HealthCare, ISSN 1877-5756, E-ISSN 1877-5764, Vol. 23, article id 100486Article in journal (Refereed) Published
Abstract [en]

OBJECTIVES: To investigate contraceptive uptake among PAC-seeking women reporting either planned pregnancies (PP) or unplanned pregnancies (UP) and to identify factors associated with UP.

STUDY DESIGN: This was a sub-study nested in randomised controlled trial (RCT) on women who sought PAC in a low-resource setting in western Kenya. The analysis was based on 807 women who were followed up at 7-10 days and by 472 women at 3 months.

MAIN OUTCOME MEASURES: Descriptive statistics and a binary logistic regression model with odds ratios (OR) and 95% confidence intervals (CI) were used.

RESULTS: Of the 807 women, 375 (46.3%) reported UP, and 432 (53.3%) PP. Most women, regardless of reported pregnancy intention, agreed to start using contraceptive methods: UP 273 (72.8%) and PP 338 (78.2%), respectively, P = 0.072. Independent factors associated with UP were young age (14-20 years; OR 1.177; 95% CI, 1.045-2.818; P = 0.033), unmarried status (OR 9.149; 95% CI, 5.719-14.638; P < 0.001), nulliparity (OR 1.968; 95% CI, 1.287-3.008; P = 0.002), concealed pregnancy (OR 7.708; 95% CI, 3.299-18.012; P < 0.001) and absence of a partner at the clinic visit (OR 3.174; 95% CI, 2.214-4.552; P < 0.001). At 3-month follow-up, there was no difference in contraceptive use between the UP group (161; 77.4%) and the PP group (193; 73.7%), P = 0.350.

CONCLUSION: Contraceptive counselling should be systematically offered to all PAC-seeking women, regardless of their stated pregnancy intention. Adolescents, unmarried women, nulliparous, women with concealed pregnancy and attending the PAC clinic without a partner should be given extra attention by PAC providers offering contraceptive counselling.

Place, publisher, year, edition, pages
2020. Vol. 23, article id 100486
Keywords [en]
Contraception, Family planning, Post-abortion care, Pregnancy intention, Unsafe abortion
National Category
Health Sciences
Research subject
Health and Welfare
Identifiers
URN: urn:nbn:se:du-31718DOI: 10.1016/j.srhc.2020.100486PubMedID: 31951913Scopus ID: 2-s2.0-85077926655OAI: oai:DiVA.org:du-31718DiVA, id: diva2:1387752
Available from: 2020-01-22 Created: 2020-01-22 Last updated: 2020-02-03Bibliographically approved

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Klingberg-Allvin, Marie

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