Post-abortion contraceptive acceptability in Blantyre, Malawi

Unsafe abortion remains one of the major reproductive and public health challenges globally, but more so in developing countries. Lack of or poor contraception has been shown to be one of predisposing factors.

To determine contraceptive acceptance amongst post-abortion patients in Blantyre, Malawi.

A cross-sectional pilot study.

The study was conducted in the gynaecological ward of the Queen Elizabeth Central Hospital, Blantyre, Malawi, the University Teaching Hospital.

A total of 464 patients were studied. Their mean age and parity were 24 (SD 6.1) and 1.5 (SD 1.9) respectively. The single comprised 20.3% and students 16.4%. The index pregnancy was reportedly unwanted by 45.3% and 17.2% said they had unsafe abortion. Of these 373 (80.4%) accepted contraception. There was no relationship between acceptance and one's age (p = 0.28), marital status (p = 0.59); or parity (p = 0.5). The most commonly chosen methods were oral pills (45.3%), DMPA (21.8%) and male condoms (20.7%). The young (<25 years old), single, more educated, and women of low parity, preferred relatively less reliable contraceptives.

The results of this study indicate that with proper planning postabortion contraception is acceptable in Malawi. It will provide an additional contraceptive service opportunity, thus increasing the currently low National CPR, and reduce repeat unwanted pregnancy, unsafe abortion, with all its potential sequel. We therefore recommend its integration into emergency post-abortion care.