Association between the place of abortion and post-abortion contraceptive adoption and continuation: the case of India

Figures & data

Table 1. Sample characteristics of women who underwent an abortion in the five years preceding the survey, NFHS-4, 2015–2016

Background characteristics	Percentage/Mean (SD)	N
Age at abortion	26.6 (5.7)	5546
Education
No education	18.8	1129
Primary	12.6	690
Secondary	53.7	2994
Higher	15.0	733
Caste
Scheduled Castes	20.7	989
Scheduled Tribes	5.9	609
Other Backward Classes	42.5	2215
Others	30.9	1733
Religion
Muslim	15.2	867
Hindu	79.7	4177
Others	5.2	502
Surviving children at the time of abortion
No child/single child	52.4	2663
Two children- 1 son and 1 daughter	13.4	768
Two children- both sons	7.1	443
Two children- both daughters	5.3	269
Three or more children- any sex	21.7	1403
Mass media exposure
No	13.4	824
Yes	86.6	4722
Wealth quintile
Poorest	12.7	739
Poorer	17.1	1095
Middle	20.8	1301
Richer	24.6	1244
Richest	25.0	1167
Place of residence
Rural	58.2	3643
Urban	41.8	1903
Region
North	11.6	922
Central	26.1	1585
East	22.8	936
Northeast	5.7	1082
West	12.5	348
South	21.4	673
Time of abortion
First trimester	91.9	5143
Second or third trimester	8.1	403
Pre-abortion contraceptive use
Did not use	74.3	4197
Modern spacing	16.9	799
Traditional spacing	8.8	550
Place of abortion
Home/others	23.9	1399
Public	21.5	1469
Private	54.6	2677
Total	100.0	5546

Figure 1. Cumulative percentages of currently married women aged 15–49 years who underwent an abortion in the past five years by their monthly/3 monthly/6 monthly contraception use after abortion, India, NFHS-4, 2015–2016

Table 2. Cumulative percentage of currently married women aged 15–49 years who underwent an abortion in five years preceding the survey by their monthly/3 monthly/6 monthly contraception use after abortion, according to the place where the abortion was conducted, India, NFHS-4, 2015–2016

Month 1
Place of abortion	Did not use	Permanent methods	IUCD	Short-acting modern methods	Traditional methods	N
Public	80.9	6.8	2.2	6.1	4.0	1469
Private	81.3	4.3	1.9	8.5	3.9	2677
Home/Others	77.1	1.4	0.6	11.7	9.1	1399
Month 3
Public	64.7	8.2	3.0	17.3	6.7	1469
Private	67.4	5.1	2.5	17.4	7.6	2677
Home/Others	55.6	2.9	1.8	23.9	15.8	1399
Month 6
Public	56.5	9.0	3.3	22.8	8.3	1469
Private	60.0	5.5	3.5	21.7	9.3	2677
Home/Others	48.7	3.4	1.9	28.4	17.5	1399
Month 12
Public	49.7	10.7	4.7	25.7	9.2	1469
Private	55.8	6.8	3.9	23.9	9.6	2677
Home/Others	43.3	5.3	2.4	29.9	19.1	1399

Table 3. Association of the socioeconomic and demographic characteristics with post-abortion contraceptive uptake using multinomial logistic regression, NFHS-4, 2015–2016

Background characteristics	Relative risk ratios (N = 5, 545)
	Permanent or IUCD vs None	Short-acting modern methods vs None	Traditional methods vs None
Age at abortion	0.99 [0.97–1.01]	0.99 [0.97–1]	1.04*** [1.02–1.06]
Education (No education^®)
Primary	1.03 [0.73–1.44]	1.3* [0.99–1.7]	1.21 [0.87–1.68]
Secondary	1.14 [0.85–1.53]	1.43*** [1.13–1.8]	1.21 [0.91–1.61]
Higher	0.97 [0.63–1.5]	1.43** [1.04–1.95]	0.99 [0.65–1.5]
Caste (Scheduled Caste^®)
Scheduled Tribe	0.81 [0.54–1.21]	0.67* [0.5–0.9]	0.8 [0.54–1.19]
Other Backward Classes	0.89 [0.68–1.16]	0.86 [0.7–1.07]	0.93 [0.71–1.23]
Others	0.89 [0.66–1.19]	0.94 [0.75–1.17]	0.91 [0.68–1.23]
Religion (Muslim^®)
Hindu	3.27*** [2.28–4.68]	0.92 [0.75–1.14]	1.25 [0.94–1.64]
Others	2.28*** [1.36–3.82]	0.62** [0.44–0.86]	0.69 [0.43–1.11]
Surviving children at the time of abortion (No child/single child^®)
Two children – 1 son and 1 daughter	8.38*** [6.16–11.41]	2.13*** [1.7–2.66]	1.86*** [1.38–2.52]
Two children – both sons	8.74*** [6.08–12.56]	2.39*** [1.82–3.14]	1.98*** [1.36–2.87]
Two children – both daughters	2.64*** [1.6–4.35]	1.24 [0.88–1.75]	1.65** [1.07–2.53]
Three or more children – any sex	10.59*** [7.54–14.86]	2.28*** [1.8–2.9]	2.41*** [1.78–3.27]
Mass media exposure (No^®)
Yes	1.43** [1.04–1.98]	1.19 [0.93–1.51]	1.1 [0.82–1.48]
Wealth quintile (Poorest^®)
Poorer	1.19 [0.84–1.68]	1.06 [0.81–1.38]	1.15 [0.82–1.59]
Middle	1.12 [0.77–1.62]	1.09 [0.83–1.45]	1.16 [0.82–1.66]
Richer	0.98 [0.65–1.48]	1.21 [0.89–1.64]	1.4* [0.95–2.05]
Richest	1.33 [0.84–2.12]	1.69*** [1.21–2.37]	1.49* [0.96–2.31]
Place of residence (Rural^®)
Urban	1.22 [0.97–1.54]	1.08 [0.91–1.28]	0.91 [0.72–1.15]
Region (North^®)
Central	0.92 [0.67–1.25]	1.04 [0.83–1.31]	1.8*** [1.32–2.45]
East	1.08 [0.76–1.55]	1.51*** [1.17–1.94]	1.32 [0.92–1.89]
Northeast	0.73 [0.5–1.08]	1.57*** [1.22–2.02]	2.21*** [1.56–3.13]
West	2.33*** [1.55–3.52]	0.84 [0.6–1.18]	0.73 [0.42–1.28]
South	1.31 [0.89–1.92]	0.24*** [0.17–0.35]	0.31*** [0.17–0.55]
Time of abortion (First trimester^®)
Second or third trimester	0.44*** [0.27–0.71]	0.61*** [0.45–0.84]	0.54** [0.35–0.85]
Pre-abortion contraceptive use (Did not use^®)
Modern spacing methods	2.71*** [2.03–3.6]	6.32*** [5.2–7.69]	2.57*** [1.91–3.44]
Traditional methods	4.19*** [2.78–6.31]	5.08*** [3.71–6.97]	27.13*** [20.11–36.61]
Place of abortion (Private^®)
Public	1.86*** [1.48–2.34]	1.15 [0.95–1.38]	0.97 [0.76–1.25]
Home/others	0.88 [0.68–1.15]	1.30*** [1.09–1.55]	1.62*** [1.30–2.03]

 Note: Significance level *p < 0.1. **p < 0.05. ***p < 0.01.

Table 4. Cumulative rate of method discontinuation after abortion among currently married women aged 15–49 years who underwent abortions in the five years preceding the survey, by method type, India, NFHS-4, 2015–2016

Contraceptive method	Rate at month 1 (%)	Rate at month 3 (%)	Rate at month 6 (%)	Rate at month 12 (%)
Overall	6.0	12.7	20.9	31.2
IUCD	4.9	11.1	15.3	24.3
Short-acting modern methods	7.2	14.6	22.7	33.7
Traditional methods	4.1	9.7	19.2	28.8

Table 5. Hazard ratios of post-abortion temporary method discontinuation from the proportional hazard models, NFHS 4, 2015–2016

Background characteristics	N = 4091 Hazard ratio [Confidence Interval]
Age at abortion	0.96*** [0.95–0.97]
Education (No education^®)
Primary	1.23** [1.00–1.51]
Secondary	1.08 [0.90–1.29]
Higher	1.08 [0.85–1.38]
Caste (Scheduled Caste^®)
Scheduled Tribe	1.20 [0.96–1.50]
Other Backward Classes	1.14 [0.97–1.34]
Others	1.20** [1.01–1.42]
Religion (Muslim^®)
Hindu	1.09 [0.93–1.28]
Others	1.09 [0.85–1.41]
Surviving children at the time of abortion (No child/single child^®)
Two children – 1 son and 1 daughter	0.66*** [0.56–0.78]
Two children – both sons	0.55*** [0.43–0.69]
Two children – both daughters	0.71** [0.55–0.93]
Three or more children- any sex	0.73*** [0.61–0.88]
Mass media exposure (No^®)
Yes	1.00 [0.84–1.21]
Wealth quintile (Poorest^®)
Poorer	1.02 [0.83–1.25]
Middle	0.98 [0.79–1.22]
Richer	0.90 [0.71–1.13]
Richest	0.70** [0.54–0.91]
Place of residence (Rural^®)
Urban	0.97 [0.86–1.11]
Region (North^®)
Central	0.76*** [0.65–0.90]
East	0.68*** [0.57–0.83]
Northeast	0.62*** [0.52–0.74]
West	0.75** [0.58–0.98]
South	1.68*** [1.30–2.15]
Time of abortion (First trimester^®)
Second or third trimester	1.20 [0.95–1.52]
Post-abortion contraceptive use (Short-acting modern methods^®)
IUCD	0.63*** [0.51–0.78]
Traditional methods	0.85** [0.76–0.96]

Note: Significance level *p < 0.1. **p < 0.05. ***p < 0.01.

Data availability statement

The dataset used in this research paper is available on the Demographic and Health Surveys (DHS) repository. The data can be downloaded from www.DHSprogram.com.