Description
ABSTRACT
Abortions account for 8 percent of maternal mortality in India and usage of contraception in post-abortal period can prevent upto 90 percent of maternal mortality associated with unsafe abortions. Providing such cases with contraception before they are discharged from the hospital or health facility will help reduce the vicious cycle of repeated unintended pregnancies and unwanted births and abortions that could ease off burden from the health system. This is a prospective analytical study conducted on patients attending the Department of Obstetrics and Gynaecology of a District Hospital in Delhi from January 2019 to June 2019 (6 months) with a diagnosis of first trimester abortion (missed, incomplete, complete) based on sonography. Knowledge, attitude and practices regarding contraception among these post-abortal women was analyzed using a pre-structured questionnaire. Changing trends in acceptance of contraception among post-abortal women from 2014 to 2019 (till June) was compared retrospectively. A total of 206 women were admitted in the hospital with a diagnosis of abortion from January 2019 to June 2019, out of which 190 women underwent Dilatation and Evacuation (D & E). Maximum women who reported to the hospital with abortion were Multigravida (60.7%). 145 women (70.3%) had D & E for incomplete abortion out of which 78 (53.8%) were induced abortion. Gradual rising trend was seen in contraceptive acceptance among post-abortal women ranging from 66.6% in January 2019 to 97.7% in June 2019. Injection MPA (Medroxy Progesterone Acetate) was the most popular contraceptive among women. 120 women (58.2%) had Inj. MPA as their contraceptive choice followed by 52 women (25.2%) who opted for Intrauterine Device (IUD) insertion as family planning method. A safe induced abortion has no negative impact on future fertility. Contraception should be started within first week of abortion as ovulation may occur as early as 8-10 days after abortion. Contraceptive counseling and provision should be an integrated part of comprehensive abortion care to help women to avoid unintended pregnancy.
Key words: Abortion, Contraception, Family Planning, Post-abortal, Pregnancy
