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PubMed2005

Unsafe abortion in Tanzania and the need for involving men in postabortion contraceptive counseling.

Targeting male partners involved in unsafe abortions for contraceptive counseling could be an important strategy for decreasing the incidence of unwanted pregnancies, yet few postabortion-care programs have attempted to involve these men. To assess the need for and determine the content of postabortion contraceptive counseling for men, this study examined the contraceptive knowledge, attitudes, and practices of male partners of women who have had an unsafe abortion. A survey was administered to 213 men accompanying female partners receiving hospital care after having undergone an unsafe abortion in Dar es Salaam, Tanzania, and 20 of these men participated in in-depth interviews. Sixteen percent of the men surveyed accompanied an extramarital partner, and of those, only 44 percent reported having practiced contraception in the last six months, compared with 81 percent of the men accompanying their wives and 83 percent accompanying their girlfriends. In general, the men wished to support their partners in practicing contraception, and the majority were willing to participate in contraceptive counseling. These findings suggest that male partners should be included in postabortion contraceptive counseling, which should be sensitive to the nature of the partners' relationship, the risk of HIV transmission, and the importance of promoting gender

Abortion, Induced↗
PubMed1988

Termination of pregnancy following diagnosis of fetal malformation: the need for improved follow-up services.

Eighty parents were offered an emotional support and counseling service following termination of pregnancy for fetal abnormality detected by second trimester ultrasound examination. Twenty couples took up the invitation to talk about their experiences. It was found that these women and their partners were profoundly affected by their decision to terminate the pregnancy. The lack of organized follow-up by existing agencies and the availability of professional support for these parents is a serious deficiency in our prenatal diagnostic services.

Abortion, Induced↗
PubMed1988

Order on the guidance file provided for in Article L. 162-3 of the Public Health Code, 29 December 1987.

Guidance files (dossiers-guides) are intended for physicians practicing in the department; in public and private hospital establishments; in family planning and family education centers; in establishments providing family information, advice, or education; in social services; and in other agencies approved by French departmental authorities responsible for health and welfare matters. The Annex sets out, on the one hand, conditions for voluntary termination of pregnancy (the legislation on voluntary termination of pregnancy, procedures to be followed, medical data, consultations following voluntary termination of pregnancy and contraception, and the costs of termination of pregnancy) and, on the other, the availability of assistance for women deciding to carry their pregnancy to term.

Abortion, Induced↗
PubMed2005

Scaling up postabortion contraceptive service--results from a study conducted among women having unwanted pregnancies in urban and rural Tanzania.

INTRODUCTION: It is well recognized that unwanted pregnancies and unsafe abortion are significant public health problems in sub-Saharan Africa. At the International Conference on Population and Development held in Cairo in 1994, postabortion care was prioritized as a means to reduce maternal morbidity and mortality associated with unsafe abortion. However, only a few postabortion care programs have been implemented and most of them have been confined to urban settings. The present study describes the magnitude of the problem of unwanted pregnancies among women with incomplete abortion in urban and rural Tanzania and evaluates the outcome of a postabortion care intervention. METHODS: Data were collected among 781 women admitted with incomplete abortion in Dar es Salaam region (urban Tanzania) and 575 women in Kagera region (rural Tanzania). RESULTS: Sixty-seven percent of the women in urban Tanzania and 42% in rural Tanzania stated that their pregnancy was unwanted. Contraceptive acceptance among women with unwanted pregnancies was high; 93% in urban Tanzania and 71% in rural Tanzania left with a contraceptive method. CONCLUSION: The high proportion of women with unwanted pregnancies in urban and rural Tanzania underlines the need of scaling up postabortion contraceptive service.

Abortion, Illegal↗
PubMed2005

A randomized controlled study comparing 600 versus 1,200 microg oral misoprostol for medical management of incomplete abortion.

OBJECTIVES: Although a number of studies have shown misoprostol's promise as a nonsurgical treatment for incomplete abortion, few have systematically examined treatment protocols. This study documents the effectiveness of 600 versus 1,200 microg oral misoprostol for this indication. METHODS: From May 2002 to January 2003, 300 women with incomplete abortion were recruited at a large tertiary facility in Vietnam and randomized to either a single-dose (600 microg) or a repeated-dose (600 microg x 2) regimen of oral misoprostol for the treatment of their condition. RESULTS: Misoprostol effectively evacuated the uterus for nearly all women (94.6%; n=279), with most reporting bleeding for 4 days (+/-2.3) and pain/cramps lasting 1 day (+/-1.0). Women indicated that the side effects were tolerable (96%) and that their experience was satisfactory (95%). CONCLUSIONS: Oral misoprostol (600 or 1,200 microg) offers a safe, effective and acceptable treatment for incomplete abortion. Larger studies to assess the advantages and disadvantages of misoprostol as compared with standard surgical care are needed to assess its role in postabortion care programs worldwide.

Abortifacient Agents, Nonsteroidal↗
PubMed2006

Acceptance and use of the female condom among women with incomplete abortion in rural Tanzania.

BACKGROUND: This study describes the outcome of a postabortion care intervention aimed at introducing the female condom as a means of preventing women from having unwanted pregnancies and sexually transmitted infections (STIs)/HIV. METHODS: Postabortion contraceptive counseling and services were offered to 548 women admitted to the Kagera Regional Hospital for incomplete abortion. The counseling included information about STI/HIV and the use male or female condom. In total, 521 (95%) women accepted contraception. RESULTS: Contraceptive use was assessed 3 months after abortion among 475 (91%) women. The female condom was accepted by 201 of 521 (39%) and was used by 158 of 521 (30%). Women who had experienced an unsafe abortion, had attended secondary school or earned an income were more likely to accept the female condom. The women were generally satisfied with the method, and the majority intended to use it again. CONCLUSION: Postabortion care programs provide an excellent entry point for introducing the female condom as a contraceptive method for the prevention of both repeat unwanted pregnancies and STI/HIV infection.

Abortion, Induced↗
PubMed1994

Induced abortion: an audit of reported current practice among consultant gynaecologists in Scotland.

OBJECTIVE: To obtain an overview of current abortion practice in Scotland for comparison with agreed criteria for good quality care based on literature review. DESIGN: Postal questionnaire survey. SUBJECTS: All 132 consultant gynaecologists practising in the NHS in Scotland. RESULTS: Response rate 92%. The survey revealed regional inequalities in the availability of services, particularly with regard to early medical abortion and second trimester procedures. It also revealed great individual variations in many areas of practice notably in screening for genital tract infection, the use of cervical predilatation, contraceptive provision, and follow up. Several aspects of practice compared poorly with the agreed criteria for good quality care. CONCLUSIONS: The postal questionnaire approach achieved a good response rate and has provided an informative overview of current practice on a national basis. Variations in the provision of services and in clinical practice, both among regions and among individual consultants, have been identified. Elements of abortion care in which great variations exist and in which current practice compares poorly with the agreed criteria have been highlighted as appropriate areas for the development of national guidelines and for educational initiatives. Such a questionnaire approach to assessing current practice can complement, and possibly replace, some aspects of casenote review audit.

Abortion, Induced↗
PubMed1977

Why 103 women asked for reversal of sterilisation.

Between 1975 and 1976 103 women requesting sterilisation reversal were interviewed at Hammersmith Hospital. Their average age at sterilisation was 26-7 years; 65 (63-1%) had been sterilised immediately after pregnancy, and many patients had previously used contraception inadequately when they were sterilised. When they had been sterilised 78 (75-7%) patients were unhappily married and remarriage was the chief reason for the request for reversal. Sexual dissatisfaction after sterilisation was common, but there was no obvious increase in menstrual disturbance. Thirty-nine (37-8%) patients had been sterilised by irreversible methods, and in only half the cases sterilised by tubal ligation were conditions technically suitable for reversal surgery. It therefore seems unwise to sterilise women under 30 particularly immediately after pregnancy or if their marriage is in jeopardy.

Adult↗