Acceptance of contraceptives among women who had an unsafe abortion in Dar es Salaam

Abstract

Objective: To assess the need for post-abortion contraception and to determine if women who had an unsafe abortion will use a contraceptive method to avoid repeated unwanted pregnancies and STDs/HIV.

Method: Women attending Temeke Municipal Hospital, Dar es Salaam, after an unsafe abortion or an induced abortion performed at the hospital (n=788) were counselled about contraception and the risk of contracting STDs/HIV. A free ward-based contraceptive service was offered and the women were asked to return for follow-up.

Results: Participants (90%) accepted the post-abortion contraceptive service. Of these, 86% stated they were still using contraception 1-6 months after discharge. Initially, 55% of the women accepted to use condoms either alone or as part of double protection. After 1-6 months this proportion had dropped to 18%. Single women were significantly more likely to use condoms.

Conclusion: High-quality contraceptive service counselling can induce women to use contraception after having had an unsafe abortion. The results of our study are encouraging and should be used to convince policy makers of the need to implement such services at municipal level to reduce the number of repeated unsafe abortions.