Do abortion users exhibit better contraceptive behaviour? Evidence from Nepal

The government of Nepal introduced Comprehensive Abortion Care (CAC) in March 2004 along with concerted efforts to improve access to modern contraception. An integral component of CAC is post-abortion contraceptive care. To date, there is no national level evidence on post-abortion contraceptive uptake in Nepal. More importantly, the interaction between abortion care and family planning is poorly understood in Nepal where abortion interventions are widely discussed in policy arena. There is also a concern that medical abortion program is promoted too aggressively in Nepal such that potential contraceptive users may have begun to opt for a ‘quick and easy fix’ thus essentially substituting abortion for contraception. Using the contraceptive calendar data drawn from the 2011 Nepal Demographic and Health Survey, this research investigates the level of contraceptive use before and after an abortion and examines the timing and determinants of post-abortion contraceptive use comparing women who had a live or still birth. Additional analysis focuses on the rates of discontinuation among users of post-abortion contraceptive method. The research is conceptualised based on the hypothesis that women who experience an abortion are generally found to be more motivated than their counterparts to use contraception in the post-abortion period.