Abstract：
BACKGROUND: Post-abortion family planning counselling and provision are known high impact practices preventing unintended pregnancies. Little is known, however, about specific needs in the second trimester. Our study aims to assess post-abortion family planning uptake and its associated factors among women with second-trimester incomplete abortion.
METHODS: We conducted a cross-sectional survey of 1191 women with incomplete second trimester abortion that received treatment at 14 comprehensive emergency obstetric care public health facilities in central Uganda from August 2018 to November 2021. We computed the post-abortion uptake of family planning within 2 weeks of treatment, described the types of methods accepted, and the reasons for declining family planning. We described the socio-demographic, reproductive, abortion-related, and health facility characteristics. We used mixed effects generalized linear models to obtain percentage differences for factors independently associated with post-abortion family planning uptake.
RESULTS: Second-trimester post-abortion family planning uptake was 65.6%. Implants (37.5%) and progestin only injectables (36.5%) were the commonly chosen methods; natural (0.1%), permanent (0.8%), and condoms (4%) were the least chosen methods. 45.2% of the women who declined family planning desired another pregnancy soon. Women whose spouses were aware of the pregnancy or had planned pregnancy had 11% (- 10.5, 95% CI - 17.1 to - 3.8) and 12% (- 11.7, 95% CI - 19.0 to - 4.4) less uptake compared to women whose spouses were not aware of the pregnancy or those with unplanned pregnancies respectively. Uptake was 8% (- 7.8, 95% CI - 12.6% to - 3.0%) lower among Islamic women compared to Anglicans. Women who received post-abortion family planning counselling or had more than four live births had 59% (59.4, 95% CI 42.1 to 76.7) and 13% (13.4, 95% CI 4.0 to 22.8%) higher uptake compared to women who did not receive counselling or women with no live births, respectively.
CONCLUSIONS: The uptake of second-trimester post-abortion family planning in Uganda was higher than previous estimates. Post-abortion family planning counselling, grand multiparity, and the need to avoid an unplanned pregnancy enhance post-abortion family planning uptake in the second trimester. Ministry of Health should strengthen post-abortion family planning counselling, especially couple counselling; at all health facilities in the country and also ensure an adequate and accessible supply of a wide contraceptive method mix.
METHODS: We conducted a cross-sectional survey of 1191 women with incomplete second trimester abortion that received treatment at 14 comprehensive emergency obstetric care public health facilities in central Uganda from August 2018 to November 2021. We computed the post-abortion uptake of family planning within 2 weeks of treatment, described the types of methods accepted, and the reasons for declining family planning. We described the socio-demographic, reproductive, abortion-related, and health facility characteristics. We used mixed effects generalized linear models to obtain percentage differences for factors independently associated with post-abortion family planning uptake.
RESULTS: Second-trimester post-abortion family planning uptake was 65.6%. Implants (37.5%) and progestin only injectables (36.5%) were the commonly chosen methods; natural (0.1%), permanent (0.8%), and condoms (4%) were the least chosen methods. 45.2% of the women who declined family planning desired another pregnancy soon. Women whose spouses were aware of the pregnancy or had planned pregnancy had 11% (- 10.5, 95% CI - 17.1 to - 3.8) and 12% (- 11.7, 95% CI - 19.0 to - 4.4) less uptake compared to women whose spouses were not aware of the pregnancy or those with unplanned pregnancies respectively. Uptake was 8% (- 7.8, 95% CI - 12.6% to - 3.0%) lower among Islamic women compared to Anglicans. Women who received post-abortion family planning counselling or had more than four live births had 59% (59.4, 95% CI 42.1 to 76.7) and 13% (13.4, 95% CI 4.0 to 22.8%) higher uptake compared to women who did not receive counselling or women with no live births, respectively.
CONCLUSIONS: The uptake of second-trimester post-abortion family planning in Uganda was higher than previous estimates. Post-abortion family planning counselling, grand multiparity, and the need to avoid an unplanned pregnancy enhance post-abortion family planning uptake in the second trimester. Ministry of Health should strengthen post-abortion family planning counselling, especially couple counselling; at all health facilities in the country and also ensure an adequate and accessible supply of a wide contraceptive method mix.
摘要：
背景：堕胎后计划生育咨询和提供是众所周知的预防意外怀孕的高影响力做法。鲜为人知，然而,关于妊娠中期的具体需求。我们的研究旨在评估孕中期不完全流产妇女的流产后计划生育摄取及其相关因素。
方法：我们对2018年8月至2021年11月在乌干达中部14个综合急诊产科公共医疗机构接受治疗的1191名妊娠中期流产不全妇女进行了横断面调查。我们计算了流产后在治疗后2周内计划生育的摄取，描述了接受的方法的类型，以及计划生育下降的原因。我们描述了社会人口统计学，生殖,与堕胎有关,和卫生设施的特点。我们使用混合效应广义线性模型来获得与流产后计划生育摄取独立相关的因素的百分比差异。
结果：流产后妊娠中期计划生育摄取量为65.6％。植入物（37.5％）和仅孕激素注射剂（36.5％）是通常选择的方法；天然（0.1％），永久性（0.8%），避孕套(4%)是选择最少的方法。拒绝计划生育的妇女中有45.2％希望尽快再次怀孕。与配偶知道怀孕或计划怀孕的妇女相比，配偶知道怀孕或计划怀孕的妇女的摄取减少了11％（-10.5，95％CI-17.1至-3.8）和12％（-11.7，95％CI-19.0至-4.4）。与英国国教徒相比，伊斯兰妇女的摄取率低8％（-7.8，95％CI-12.6％至-3.0％）。接受过堕胎后计划生育咨询或有四次以上活产的妇女与没有接受咨询的妇女或没有活产的妇女相比，有59%(59.4,95%CI42.1至76.7)和13%(13.4,95%CI4.0至22.8%)的摄取更高。分别。
结论：乌干达孕中期流产后计划生育的发生率高于以前的估计。堕胎后计划生育咨询，巨大的多重奇偶校验，和需要避免意外怀孕增加了流产后计划生育在妊娠中期的接受。卫生部应加强堕胎后计划生育咨询,特别是夫妇咨询；在该国所有的卫生设施，并确保充足和可获得的广泛避孕方法组合的供应。
方法：我们对2018年8月至2021年11月在乌干达中部14个综合急诊产科公共医疗机构接受治疗的1191名妊娠中期流产不全妇女进行了横断面调查。我们计算了流产后在治疗后2周内计划生育的摄取，描述了接受的方法的类型，以及计划生育下降的原因。我们描述了社会人口统计学，生殖,与堕胎有关,和卫生设施的特点。我们使用混合效应广义线性模型来获得与流产后计划生育摄取独立相关的因素的百分比差异。
结果：流产后妊娠中期计划生育摄取量为65.6％。植入物（37.5％）和仅孕激素注射剂（36.5％）是通常选择的方法；天然（0.1％），永久性（0.8%），避孕套(4%)是选择最少的方法。拒绝计划生育的妇女中有45.2％希望尽快再次怀孕。与配偶知道怀孕或计划怀孕的妇女相比，配偶知道怀孕或计划怀孕的妇女的摄取减少了11％（-10.5，95％CI-17.1至-3.8）和12％（-11.7，95％CI-19.0至-4.4）。与英国国教徒相比，伊斯兰妇女的摄取率低8％（-7.8，95％CI-12.6％至-3.0％）。接受过堕胎后计划生育咨询或有四次以上活产的妇女与没有接受咨询的妇女或没有活产的妇女相比，有59%(59.4,95%CI42.1至76.7)和13%(13.4,95%CI4.0至22.8%)的摄取更高。分别。
结论：乌干达孕中期流产后计划生育的发生率高于以前的估计。堕胎后计划生育咨询，巨大的多重奇偶校验，和需要避免意外怀孕增加了流产后计划生育在妊娠中期的接受。卫生部应加强堕胎后计划生育咨询,特别是夫妇咨询；在该国所有的卫生设施，并确保充足和可获得的广泛避孕方法组合的供应。
