Emergency contraception and prevention of induced abortion in India.
OBJECTIVE
Induced abortion is associated with high morbidity and mortality in India. Use of regular contraception with emergency contraception (EC) as backup can reduce the incidence of induced abortion. The study aimed to assess women's knowledge, practice, preference and acceptance of different contraceptive methods with special reference to the causes of induced abortion, and their willingness to use hormonal EC.


METHODS
The study comprised a structured questionnaire survey conducted in the family planning clinic of a tertiary teaching hospital in New Delhi, India. A total of 623 women and three men seeking contraceptive advice and/or termination of pregnancy were interviewed. The main outcome measures were knowledge of different contraceptive methods including EC and the reasons for unintended pregnancy.


RESULTS
More than 99% of the respondents knew about most of the modern methods of contraception whereas only 37 (5.9%; 95% CI 4.0-7.8) of the respondents knew about EC and none of them had ever used it. Contraceptive method failure led to unintended pregnancy in 39.1% (95% CI 33.7-44.5) of abortion seekers. Correct use of EC could have prevented nearly 65.5% (95% CI 57.0-74.0) of induced abortions due to contraceptive method failure and 25.6% (95% CI 20.7-30.5) of all induced abortions.


CONCLUSIONS
More efforts are required to generate awareness about the safety, efficacy and availability of EC, regular use of effective contraception and the health hazards of induced abortion.
Arora
Nalini
N
Department of Obstetrics and Gynaecology, Lady Hardinge Medical College, New Delhi, India. njana1@vsnl.net
Mittal
Suneeta
S
D000028:Abortion, Induced; D000293:Adolescent; D000328:Adult; D002983:Clinical Competence; D003278:Contraceptives, Oral, Hormonal / Q000627:therapeutic use*; D004363:Drug Utilization; D005193:Family Planning Services; D005260:Female; D019538:Health Care Surveys; D007722:Health Knowledge, Attitudes, Practice; D006784:Hospitals, Teaching; D006801:Humans; D007194:India; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D049168:Pregnancy, Unplanned; D011446:Prospective Studies; D011795:Surveys and Questionnaires
D003278:Contraceptives, Oral, Hormonal