Voluntary Contraceptive Uptake Among Postabortion Care Clients Treated With Misoprostol in Rwanda

Figures & Tables

TABLE 1.

PAC Client Sociodemographic and Reproductive Health Characteristics (N=68)

	Value
District, No. (%)
Gisagara	29 (43)
Bugesera	28 (41)
Kicukiro	11 (16)
Number of PAC clients by facility type, No. (%)
District hospital (4)	33 (49)
Health center (13)	35 (51)
Age, years, mean (range)	29.5 (19, 46)
Highest educational level attended, No. (%)
Did not attend school	7 (10)
Primary	53 (78)
Secondary	8 (12)
Has a paid job, No. (%)	4 (6)
Marital status, No. (%)
Currently married	50 (74)
Not married but living with partner	14 (21)
Not married but has boyfriend	2 (3)
Single, not in union	2 (3)
Has living child(ren), No. (%)	47 (69)
Has ever used a contraceptive method, No. (%)	48 (71)
Prior contraceptive method used, No. (%)
Oral contraceptives	19 (28)
Injectables	36 (53)
Male condoms	5 (7)
Implants	2 (3)
CycleBeads	1 (1)
Was using method when became pregnant, No. (%)	11 (16)
Future pregnancy plans, No. (%)
Immediately	6 (9)
Wait to become pregnant	41 (60)
Never want to become pregnant again	11 (16)
Do not think can get pregnant	9 (13)
Do not know	1 (1)

TABLE 2.

PAC Client Contraceptive Counseling and Uptake (N=68)

	No. (%)
Client counseling
Not told when they could become pregnant again	27 (40)
Counseled to wait at least 6 months before becoming pregnant	33 (49)
Counseled on voluntary family planning	64 (94)
Contraceptive uptake
Chose and received method before facility discharge	32 (47)
Using method at time of survey	48 (71)
Method using at the time of the survey^a
Injectable	22 (46)
Oral contraceptives	10 (21)
Male condom	9 (19)
Implant	3 (6)
CycleBeads	2 (4)
Missing	2 (4)
Reasons for nonuse^b
Wanted to get pregnant	6 (30)
Thinks unable to get pregnant	3 (15)
Disapproves of family planning	2 (10)
Believes body is weak/needs to recover	3 (15)
Reports family planning not available	2 (10)
Has infrequent sex or is no longer with partner	1 (5)
Worries that bleeding is too much	1 (5)

TABLE 3.

PAC Provider Sociodemographic Characteristics and PAC Experience (N=43)

	No. (%)
District
Gisagara	19 (44)
Bugesera	19 (44)
Kicukiro	5 (12)
Number of providers by facility type
District hospital (4)	17 (40)
Health center (12)	26 (60)
Sex
Male	15 (35)
Female	28 (65)
Age, years, mean (range)	32 (25–52)
Job title
Nurse	36 (84)
Physician	3 (7)
Midwife	4 (9)
Length of time providing PAC
<6 months	12 (28)
6 months to 1 year	3 (7)
1–5 years	15 (35)
>5 years	13 (30)
Participated in VSI/RMOH training on misoprostol for PAC	31 (72)

Abbreviations: PAC, postabortion care; RMOH, Rwanda Ministry of Health; VSI, Venture Strategies Innovations.

TABLE 4.

PAC Providers’ Experience Providing Contraceptive and Pregnancy Counseling (N=43)

	No. (%)
Talked to PAC clients about future plans to have children^a	43 (100)
Thinks PAC clients can become pregnant again:
Within 10 days of treatment	28 (65)
After 1 month or more post treatment	11 (26)
Tells PAC clients to wait 6 months before becoming pregnant again	40 (93)
Feels has enough time to counsel/refer PAC clients to voluntary contraception	29 (67)
Counseled PAC clients on voluntary contraception/referred them to secondary health post for method^a	43 (100)
Discusses long-acting and permanent methods
IUD	28 (65)
Implants	33 (77)
Female sterilization^b	8 (19)
Vasectomy	7 (16)
Discusses short-acting methods
Oral contraceptives	36 (84)
Injectables	39 (91)
Male condoms	24 (56)
Female condoms	13 (30)
Emergency contraception pills	4 (9)
Discusses fertility awareness methods
CycleBeads^c	9 (21)
Provider personally gives contraceptive methods to PAC clients	32 (74)

Abbreviation: PAC, postabortion care.
↵a In the past 3 months.
↵b PAC clients are generally asked to return to the facility to seek this procedure.
↵c This method cannot be initiated by a PAC client until return to normal menses; this is important to avoid a future unintended pregnancy.

TABLE 5.

PAC Providers’ Postabortion Contraceptive Knowledge and Opinions (N=43)

	No. (%)
Reported there are methods that should never be used by PAC clients	24 (56)
Methods believed should never be used by PAC clients
IUD	16 (37)
Implants	1 (2)
Injectables	1 (2)
CycleBeads	4 (9)
Female sterilization	2 (5)
Any traditional method	1 (2)
No response	1 (2)
Agreed with statement: “Unmarried women should not have sex until marriage.”	41 (95)
Agreed with statement: “Giving family planning to PAC patients under 20 years old will motivate them to have sex.”	18 (42)