Abortion history and its association with current use of modern contraceptive methods in Luanda, Angola

Women in sub-Saharan Africa often use abortion as a method of limiting their fertility and spacing births. However, it is not well understood whether having an abortion influences contraceptive behavior. The goal of this study was to examine associations between abortion history and use of a modern contraceptive method among women in Luanda, Angola.

We analyzed data on 1,176 women aged 15-49 years from a 2012 cross-sectional study conducted in Luanda, Angola, which aimed to obtain general information on sexual and reproductive health indicators. The outcome and exposure were based on participant reports of past induced abortions and current use of a modern method. We used a modified Poisson regression with robust standard errors to estimate the relative risks of using a modern contraceptive method, given history of induced abortion.

Among all respondents, 736 (62.6%) reported using a modern contraceptive method. The clear majority of the respondents (73.21%), regardless of abortion history, were using either no method, a traditional method, or condoms. Long-acting reversible contraceptive use was very low across all respondents (2.73%). The most common family planning method reported by women with a history of abortion was condoms (32.76%). Regression analysis demonstrated that women who had a history of abortion were 1.23 times more likely to use a modern contraceptive method as compared to those who never had an abortion (relative risk: 1.23; 95% CI: 1.10-1.36), after adjusting for potential confounders. Postregression estimations of predicted probabilities demonstrated that women with a history of abortion had an 80% probability of using a modern method (95% CI: 0.76-0.84), while those who never had an abortion had a 60% probability of using a modern method (95% CI: 0.59-0.61).

History of induced abortion was associated with use of a modern contraceptive method in our study population. The most common contraceptive used by women with a history of induced abortion was condoms, indicating that despite adoption of a modern method, many women are still at risk for an unintended pregnancy. Further research is needed to understand the causal factors underlying women's postabortion contraceptive choices.