Uptake of Contraception following Childbirth or Pregnancy Termination: Implications for Quality of Care in Developing Countries

Mohamed M. Ali, World Health Organization (WHO)
Iqbal H. Shah, World Health Organization (WHO)

The analysis will make use of DHS calendar data on dates of birth and pregnancy terminations and durations of postpartum amenorrhoea, abstinence, breastfeeding and contraceptive uptake in 19 countries. The main emphasis of the paper will be on behavior following live births, in terms of contraceptive uptake, discontinuation and switching, but post-pregnancy termination events will also be examined. The mean duration of postpartum infecundability ranged from 3.9 to 10.1 months and breast-feeding from 7.1 to 18.8 months. More than two in five episodes have started during the period of postpartum infecundability (with mean overlap duration ranging from 4.3 month in Turkey to 8.7 months in Zimbabwe). The overall 12-month discontinuation rates ranged from 19 in Zimbabwe to 58 in Dominican Republic. A similar range was observed for injectables. Condom discontinuation tended to be higher than for hormonal methods but IUD discontinuation was much lower.