Contraceptive Choices And Determinants Of Uptake Following Abortion: Insights From A Tertiary Care Centre In Uttar Pradesh, India

Abstract

Background: Post-abortion contraception is critical in preventing repeat unintended pregnancies and reducing maternal morbidity. This study aimed to assess the prevalence, preferences, and determinants of contraceptive acceptance among women receiving abortion care at a tertiary centre in Uttar Pradesh.

Methods: A cross-sectional study was conducted among 196 women who received post-abortion care. Data on socio-demographic characteristics, contraceptive counselling, acceptance, and method preferences were collected. Bivariate and multivariate logistic regression analyses were used to identify factors associated with contraceptive uptake.

Results: The mean age of participants was 26.4 ± 5.8 years. Most women were married (93.4%), lived in urban areas (59.2%), and had secondary education or higher (62.8%). Post-counselling, contraceptive acceptance significantly increased from 61.7% to 69.9% (p = 0.031). Among 137 acceptors, barrier methods were most preferred (38.2%), followed by injectables (33.6%), IUCDs (11.7%), oral pills (10.2%), and sterilization (6.3%).

Bivariate analysis showed that younger age (p = 0.018), higher education (p = 0.006), urban residence (p = 0.022), multiparity (p = 0.011), and partner support (p < 0.01) were significantly associated with acceptance. In multivariate regression, independent predictors included age 18–25 years (AOR: 2.21; p = 0.021), higher education (AOR: 2.78; p = 0.003), urban residence (AOR: 1.89; p = 0.037), multiparity (AOR: 2.33; p = 0.023), and partner involvement (AOR: 3.45; p < 0.001). Model fit was satisfactory (Hosmer-Lemeshow p = 0.68; AUC = 0.77).

Conclusions: Post-abortion contraceptive counselling significantly improves uptake. Preferences leaned towards reversible, short-acting methods. Younger age, higher education, urban residence, multiparity, and partner involvement were key determinants. Integrating timely counselling and addressing barriers like fear of side effects and cultural misconceptions is crucial for optimizing contraceptive services in post-abortion care.