Contraception needs and induced abortion in China: two cross-sectional studies
Wei-Hong Zhang1 ,2, Shangchun Wu3, Marleen Temmerman1 ,4
1International Centre for Reproductive Health (ICRH), Ghent University, Ghent, Belgium, 2Research Labouratory for Human Reproduction, Faculty of Medicine, Université Libre de Bruxelles (ULB), Brussels, Belgium, 3The national Research Institute for Family Planning (NRIFP), China, Beijing, China, 4The department of Obstetrics and Gynecology, Women’s health Centre of Excellent East-Africa, the Faculty of Health Science, Aga Khan University, Nairobi, Kenya
Objective: In China, the official estimated annual number of induced abortions ranges from 7 million to 13 million in recent years. Chinese family planning (FP) services, with a major concern on birth control among married couples, have been a political priority for more than thirty years prior to the two child policy implemented recently. Abortion is commonly used to end unintended pregnancy. This study aimed to describe the characteristics of abortion seekers in two, time periods of studies in China.
Methods: Two cross-sectional surveys were conducted in 2005 and 2013 respectively and similar methods were used for collecting data. A questionnaire was completed by abortion service providers for all women seeking abortion within 12 weeks of pregnancy during a period of two months. The information included self-reported demographic & economic characteristics, history of induced abortion and practices regarding contraception. Twenty-four hospitals from 3 cities in 2005 and 295 hospitals from 30 provinces in 2013 participated in the studies, respectively.
Results: Total numbers of participants consisting of 7291 in 2005 and 79,174 in 2013 were included in the analysis. A higher proportion of subsequent induced abortions were reported in 2013 (65%) than in 2005 (35%). The main reason of current unintended pregnancy was non-use of any contraception (65.1%) in 2005 and failure of contraception (50.3%) in 2013. Condoms were the most used contraceptive method among married and unmarried women in both periods of studies, but the proportions of consistent and correct utilisation of condoms were low in both time periods.
Conclusion: The large numbers of induced abortions are primarily due to contraceptive failure or no use of contraception. Postabortion FP services are often lacking in hospital settings where the majority of induced abortions were performed. Integrating postabortion family planning into the existing health system is urgently needed and is an opportunity and a challenge in China.