Postabortion Contraceptive Utilization, Preferences, and Associated Factors among Women Receiving Abortion Care Services in Health Facilities of Ambo Town, Ethiopia

Abstract

Background. The World Health Organization recommends the use of effective contraception for the prevention of unintended pregnancy and unsafe abortion. The main aim of postabortion contraceptive services is to prevent recurrent pregnancy and ultimately mitigate the associated maternal mortality. Objective. To assess postabortion contraceptive utilization (PACU) and postabortion contraceptive preferences (PACP) and the associated factors among women receiving abortion care services in Ambo town, Oromia Region, Western Ethiopia. Methods. A cross-sectional study was conducted at the health facilities in Ambo town from 22 July to 24 September 2021. The data was collected using a structured questionnaire. Bivariate and multivariable logistic regression was done to determine the factors associated with postabortion contraceptive utilization and preferences. Results. Out of 388 participants who were included in the final analysis, 262 (67.5%) had utilized postabortion contraceptives of which 173 (66%) received contraceptive methods of their primary preference. The multivariate logistic regression showed that cohabiting couples showed lower utilization ( $\text{AOR}=0.15$ ; 95% CI: 0.06-0.21; $p$ value = 0.004) than married ones and planning to have an additional child within 1-3 years ( $\text{AOR}=7.41$ ; 95% CI: 2.18-11.41; $p$ value = 0.005) or after 3-5 years ( $\text{AOR}=6.67$ : 95% CI: 5.12-10.18; $p$ value = 0.033) was identified to be significantly associated with postabortion contraceptive utilization. Having a secondary education level ( $\text{AOR}=3.06$ ; 95% CI: 1.54-6.07; $p$ value = 0.001) and having experience of domestic violence ( $\text{AOR}=2.19$ ; 95% CI: 1.27-3.81; $p$ value = 0.005) were significantly associated with unsatisfied postabortion contraceptive preference. Conclusions and Recommendations. About two-thirds of the women who were given abortion services received postabortion contraceptives whereas almost two-thirds of them received a contraceptive method of their primary preference. Marital status, duration before additional child planned, and being counseled on contraceptive determined postabortion contraceptive utilization. Having a secondary education level and having experienced domestic violence were significantly associated with unsatisfied PACP.