Post-abortion contraceptive use and continuation in Nepal

Introduction: The study examines post-abortion contraceptive use over 12 months among women receiving induced abortion services in Nepal.
Data and Methods: The data are from a prospective cohort study of abortion clients at four health facilities. Overall, 838 women were enrolled; 654 completed 6-month interviews, and 624 completed 12-month interviews. Life table analysis methods were used to estimate contraceptive continuation and pregnancy. Further analyses will be conducted using Cox proportional hazards models to estimate factors associated with method continuation and pregnancy.
Results: At baseline, 57% of women reported adopting a modern method of contraception. This percentage dropped to 52% at 6 months and 50% at 12 months, with changes in the methods used. The overall contraceptive continuation rate for female controlled effective modern methods was 58.2 per 100 person-years. The continuation rate for the injectable was 49.6/100 person-years and for the pill was 63.8/100 person years. Although few women initiated use of long-acting reversible contraception (3.5%), continuation rates were higher for these methods than for the pill or injectable (92.3/ 100 person years, p <.01).
Conclusions: The results suggest a need to increase use of modern contraceptives by improving service quality, particularly counselling.