Immediate post-abortion intra-uterine devices uptake and associated factors at the emergency gynecology unit of Mulago Hospital

Abstract

Introduction: The immediate post-abortion period is challenging as the woman can get pregnant as early as the 8th day. Therefore, providing an effective long acting method of contraception during this period reduces the risk of unintended pregnancy and the associated complications. The Intra-Uterine Device is effective, safe and reduces repeat abortions. This study was conducted to determine the uptake of immediate post-abortion IUD and the factors associated. Methods: This was a cross-sectional study. Eligible women who had been managed for abortion at the emergency gynecology ward of Mulago hospital were enrolled by consecutive sampling. Those who consented to participate in the study had a questionnaire completed on their biodata, method of contraception taken up and factors that could possibly affect IUD uptake. Immediate postabortion IUD uptake was calculated as number of women who had an IUD inserted over total number recruited in the study. The factors affecting immediate post-abortion IUD uptake were determined by bivariate and multivariate logistic regression. Results A total of 593 women who had received post-abortion care were enrolled. The Immediate postabortion IUD uptake was 5% (CI 4-7). Women who were in the age group of 25-29 years were 5 times more likely to take up an IUD compared to those of 15-19 years (p value 0.047). 81% of women who had ever used an IUD were less likely to take it up in the immediate post-abortion period (p value 0.001). While 65% of women who had ever used any form of contraception prior were also less likely to take up the IUD (p value 0.024). Conclusion: Immediate post-abortion IUD uptake is higher than IUD prevalence nationwide, therefore women should be counseled and offered the IUD in the immediate post-abortion period.