Interval versus postabortive counseling: demographic characteristics and
effect of reproductive desire on method selection (14332 cases)
K. Ertopçu, M.
Inal, A. Dönmez, I. Özelmas, S. Tinar
SSK (Social Security Agency) Aegean
Maternity Hospital, Family Planning Department, Izmir, Turkey
Objective: To
compare the demographic characteristics, reproductive desire and selected
contraceptive methods of cases who had applied to our clinics in interval period
and for uterine evacuation of pregnancy.
Materials and Methods: 8308 cases who
had applied to our clinic for contraceptive method application in interval
period and contraceptive method applied 6024 cases after uterine evacuation in
between 01.01.1999 and 31.07.2003 were enrolled into the study. Demographic
characteristics like age, education status, number of alive children and former
contraceptive methods of the cases were recorded. Reproductive desire of the
cases were evaluated. Contraceptive methods of both groups selected after
counseling were analysed. Statistical data were evaluated with chi-square test.
Results: Fiftysix percent of the applicants were graduates of primary school (This
rate was 59% in the uterine evacuation group and 54% in interval group). 50% of
the cases were in between 21–31 years of age (52% of the uterine evacuation
group and 50% of the interval group). Cases older than 43 years were 9% of the
interval group and 3% of the postabortive group. 41% of the cases had 2 children,
28% of the cases with 1 child and 20% of the cases had 3 children. 63% of the
cases had no desire for more children (This rate was 66% in uterine evacuation
group and 16% in interval group). The rates of the selected contraceptive
methods of 14332 cases were as follows: intrauterine device (IUD) 49%, oral
contraceptive (OC) 28%, Depotmedroxyprogesterone acetate (DMPA) 10%, surgical
sterilization 6%, monthly injection 5% and vasectomy 2%. These rates were 58%
IUD, 22% OC, 7% DMPA, 7% monthly injection and 6% surgical sterilization after
the uterine evacuations. 49.4% of primary school graduates preferred IUD, 26.7%
preferred OC, 11% preferred DMPA, 6.4% preferred surgical sterilization (tubal
ligation), 4.9% preferred monthly injection and 1.3% preferred vasectomy. These
rates were IUD in 45.1%, OC in 34.3%, DMPA in 9.8%, monthly injection in 5.7%,
surgical sterilization (tubal ligation) in 3.9% , vasectomy in 0.8% of
high-school graduates. IUD was the most preferred contraceptive method among all
of the age groups with a rate over 50%. Fiftyone percent of the surgical
sterilization applied cases had three or more children, 38% had 2 children and
2% had one child. 52.6% of 3095 cases with no previous contraceptive method
preferred IUD and 21.3% preferred OC. 58.6% of the 3800 cases using coitus
interreptus as contraceptive method preferred IUD and 19.2% preferred OC. 49.4%
of the 1834 cases using IUD as contraceptive method preferred IUD and 27.3%
preferred OC. 15.5% of the 1830 cases using OC as contraceptive method preferred
OC again. IUD, OC, DMPA and monthly injection were chosen by 3050 cases (who
desire children after 2 years) with rates of 49.7%, 32.5%, 12.2% and 5.5%,
respectively.
Conclusions: Socio-cultural levels of the cases applied for
uterine evacuation were observed to be lower. Post-abortive counseling was found
to be effective in method selection. The most frequently chosen contraceptive
method was found to be IUD, whereas oral contraceptives and monthly injections
were preferred more frequently than the other groups in group with high
education level.
