Postabortion contraceptive use and method continuation in India

Objective: To investigate the patterns and determinants of postabortion contraceptive use and the rates of method continuation in India. Methods: Population-level retrospective calendar data on 5135 married women who had their last abortion during the 60 months preceding the survey were drawn from 2005-2006 Indian National Family Health Surveys. Multinomial logistic regression was used to model the factors associated with postabortion method choices. Method discontinuation rates were estimated using proportional hazard models. Results: Overall, 70.4% of women reported not using any method following abortion, and the levels varied considerably across states. Significant differences were observed in the type of method adopted by women living in large cities, small towns, and rural areas. Poor and socially excluded women were less likely to use any method after abortion, particularly modern reversible methods. Method discontinuation rates were considerably higher among socially disadvantaged groups. Conclusion: Postabortion contraceptive adoption is exceptionally low in India. Reproductive health interventions should urgently consider implementing comprehensive postabortion care policies, integrating family planning with sexual and reproductive healthcare services, and in particular targeting women from disadvantaged communities. Crown Copyright (C) 2012 Published by Elsevier Ireland Ltd. on behalf of International Federation of Gynecology and Obstetrics. All rights reserved.