Long-acting reversible contraceptive use in the post-abortion period among women seeking abortion in mainland China: intentions and barriers

Background: This study aimed to describe the intentions of and barriers to the use of long-acting reversible contraceptives (LARCs) in the post-abortion period among women seeking abortion in mainland China. Methods: A cross-sectional study was conducted from July 2015 to December 2015 using a waiting room questionnaire. A total of 381 women seeking abortions were recruited at a public hospital abortion clinic. The outcome variable was an 'intention-to-use' LARCs in the immediate post-abortion period. Chi-square tests were used to assess associations between categorical variables. Statistically significant variables (p <= 0.05) were then further analyzed by logistic regression. Results: Among 381 respondents, 42.5% intended to use LARCs in the immediate post-abortion period; 35.2% intended to use intra-uterine devices (IUDs); and 13.9% intended to use implants. Previous use of LARC was a predictor for an intention to use LARCs (odds ratio [OR] = 2.41; 95% confidence interval [CI]: 1.06-5.47). Participants with one or no child had reduced odds for an intention to use LARC (OR = 0.32, 95% CI: 0.15-0.47 and OR = 0.29, 95% CI: 0.13-0.68, respectively). Women with a higher sex frequency (at least once per week) showed increased odds for LARC use (OR = 3.34; 95% CI: 1.03-10.78) and married women were more likely to use LARC than single women (OR = 1.57; 95% CI: 1.00-2.47). Women who planned to have another baby within two years were more likely not to use LARCs in the immediate post-abortion period (OR = 0.97; 95% CI: 0.43-2.12). Barriers to the use of LARCs were anxiety relating to impaired future fertility (56.2%), LARCs being harmful to health (45.2%), irregular bleeding (44.3%), risk of IUD failure (41.6%) and lack of awareness with respect to LARCs (36.1%). Conclusions: Intention to use LARCs was predicted by marital status, frequency of sexual activity, number of children, planned timing of next pregnancy, and previous LARC use. Impaired future fertility, being harmful to health, irregular bleeding, risk of complications, and lack of awareness with regards to LARCs were the main barriers in their potential use.