TY - JOUR
T1 - Contraceptive receipt among first-trimester abortion clients and postpartum women in urban mexico
AU - Darney, Blair G.
AU - Fuentes-Rivera, Evelyn
AU - Saavedra-Avendaño, Biani
AU - Sanhueza-Smith, Patricio
AU - Schiavon, Raffaela
N1 - Funding Information:
Blair G. Darney, Evelyn Fuentes-Rivera and Biani Saavedra-Avendaño were partially supported by the Society of Family Planning Research Fund (award SFPRF11–02). Blair G. Darney was partially supported by grant number K12HS022981 from the Agency for Healthcare Research and Quality (AHRQ), HHS. The content is solely the responsibility of the authors and does not necessarily represent the official views of the AHRQ.
Funding Information:
Blair G. Darney, Evelyn Fuentes-Rivera and Biani Saavedra-Avenda?o were partially supported by the Society of Family Planning Research Fund (award SFPRF11?02). Blair G. Darney was partially supported by grant number K12HS022981 from the Agency for Healthcare Research and Quality (AHRQ), HHS. The content is solely the responsibility of the authors and does not necessarily represent the official views of the AHRQ.
Publisher Copyright:
© 2020, Guttmacher Institute. All rights reserved.
Copyright:
Copyright 2021 Elsevier B.V., All rights reserved.
PY - 2020
Y1 - 2020
N2 - CONTEXT: In Mexico, first-trimester abortion is legal in Mexico City and is available in the public and private sectors. Understanding subsequent contraceptive uptake and method mix among first-trimester abortion clients relative to that of women who deliver a live birth at a health facility could help identify where improvements in care following an obstetric event can be made across the health system. METHODS: This article uses a retrospective cohort study to compare uptake of contraception prior to discharge between abortion clients in Mexico City’s public abortion program and postpartum women from urban settings. The two data sources were clinical records of 45,233 abortion clients in Mexico City and information from a population-based survey of 1,289 urban women on their immediate postpartum contraceptive adoption. The primary outcome investigated was receipt of any reversible modern contraceptive method; secondary outcomes were level of method effectiveness and method type. Logistic regression and calculated multivariable probabilities were used to control for the effects of sociodemographic factors across the two data sources. RESULTS: The adjusted probability of uptake of any reversible modern method of contraception was higher among abortion clients than among postpartum women (67% vs. 48%). However, among all women who had received a contraceptive method, abortion clients had a lower adjusted probability of having received a long-acting reversible contraceptive than did postpartum women (49% vs. 82%) and a higher probability of having received a moderately effective method (38% vs. 13%). The adjusted probability of implant uptake was higher among abortion clients than among postpartum women (9% vs. 3%), while the adjusted probability of IUD uptake was lower (38% vs. 78%). CONCLUSIONS: Women receiving abortions in Mexico City’s public abortion program were more likely than urban postpartum women to receive a reversible modern contraceptive method before leaving the facility. Women should be offered the full range of contraceptive methods after any obstetric event, to help them prevent unintended pregnancy and avoid short interpregnancy intervals.
AB - CONTEXT: In Mexico, first-trimester abortion is legal in Mexico City and is available in the public and private sectors. Understanding subsequent contraceptive uptake and method mix among first-trimester abortion clients relative to that of women who deliver a live birth at a health facility could help identify where improvements in care following an obstetric event can be made across the health system. METHODS: This article uses a retrospective cohort study to compare uptake of contraception prior to discharge between abortion clients in Mexico City’s public abortion program and postpartum women from urban settings. The two data sources were clinical records of 45,233 abortion clients in Mexico City and information from a population-based survey of 1,289 urban women on their immediate postpartum contraceptive adoption. The primary outcome investigated was receipt of any reversible modern contraceptive method; secondary outcomes were level of method effectiveness and method type. Logistic regression and calculated multivariable probabilities were used to control for the effects of sociodemographic factors across the two data sources. RESULTS: The adjusted probability of uptake of any reversible modern method of contraception was higher among abortion clients than among postpartum women (67% vs. 48%). However, among all women who had received a contraceptive method, abortion clients had a lower adjusted probability of having received a long-acting reversible contraceptive than did postpartum women (49% vs. 82%) and a higher probability of having received a moderately effective method (38% vs. 13%). The adjusted probability of implant uptake was higher among abortion clients than among postpartum women (9% vs. 3%), while the adjusted probability of IUD uptake was lower (38% vs. 78%). CONCLUSIONS: Women receiving abortions in Mexico City’s public abortion program were more likely than urban postpartum women to receive a reversible modern contraceptive method before leaving the facility. Women should be offered the full range of contraceptive methods after any obstetric event, to help them prevent unintended pregnancy and avoid short interpregnancy intervals.
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U2 - 10.1363/46e0720
DO - 10.1363/46e0720
M3 - Article
C2 - 33326398
AN - SCOPUS:85098606763
VL - 46
SP - 35
EP - 43
JO - International Perspectives on Sexual and Reproductive Health
JF - International Perspectives on Sexual and Reproductive Health
SN - 1944-0391
ER -