Birth Control After Abortion Is Thin in Northern Ethiopia

In conflict-affected parts of northern Ethiopia, birth control after abortion is not always easy to reach. Women and girls who get care for incomplete or induced abortions can face a real risk of another unplanned pregnancy. This risk matters because humanitarian zones often have limited services. The Amhara region has seen conflict, and evidence about contraception after abortion there has been thin.

Researchers used a facility-based cross-sectional design to collect data from 1,642 participants. They worked in 31 public health facilities across seven humanitarian zones. A semi-structured questionnaire gathered the information. A binary logistic regression model helped spot factors linked with post-abortion contraceptive use. Adjusted odds ratios and 95% confidence intervals were reported when p-values were below 0.05.

Overall, 27.8% of participants used contraception after abortion. The 95% confidence interval was 25.6% to 30%. Single participants had higher odds, with an adjusted odds ratio of 1.96 and a 95% confidence interval from 1.39 to 2.75. Participants with a previous induced abortion also had higher odds, at 2.00, with a range from 1.42 to 2.83. Those who received a high level of person-centered comprehensive abortion care had the strongest boost, at 3.39, with a range from 2.39 to 4.82. A past spontaneous abortion was linked with lower odds, at 0.73, with a range from 0.55 to 0.97.

The low uptake points to a service gap. Without timely, accurate, and accessible contraceptive counseling and services, repeat unintended pregnancies may become more common. That can add strain to women and to the health system. Strengthening high-level person-centered comprehensive abortion care for all women is one way to close the gap.