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Contraception, pregnancy, and induced abortion within 24 months of delivery in eastern, central, and western regions of China: a retrospective cohort study
  • +15
  • Yan Che,
  • Yuyan Li,
  • Xiangying Gu,
  • Lifang Jiang,
  • Yuanzhong Zhou,
  • Xiaoyu Hu,
  • Li Jiang,
  • Tongying Cheng,
  • Dong Xiao Jing,
  • Xiaochen Huang,
  • Yongfeng Luo,
  • Wen Lv,
  • Guangli Qiao,
  • Jiandong Song,
  • Wei Xia,
  • Linai Zhang,
  • Yanfei Zhou,
  • Yan Zhang
Yuyan Li
1. NHC Key Lab. of Reproduction Regulation(Shanghai Institute of Planned Parenthood Research), School of Public Health, Fudan University
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Xiangying Gu
Tianjin Medical University General Hospital
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Lifang Jiang
Henan Key Laboratory of Population Defects Prevention, Henan Provincial Research Institute for Population and Family Planning;
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Yuanzhong Zhou
School of Public Health, Zunyi Medical University
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Xiaoyu Hu
Shanghai Women's and Children Health Center
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Li Jiang
Maternal and Child Health Hospital of Guangxi Zhuang Autonomous Region
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Tongying Cheng
Xinjiang Urumqi Maternal and Child Health Hospital
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Dong Xiao Jing
The second affiliated hospital of Chongqing Medical University
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Xiaochen Huang
Fujian Maternity and Children Health Hospital
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Yongfeng Luo
Jilin Guojian maternity hospital
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Wen Lv
Tongde Hospital of Zhejiang Province
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Guangli Qiao
Health and Reproductive Health Technical Guidance Service Center of Ningxia Hui Autonomous Region
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Jiandong Song
Affiliated Hospital of Inner Mongolia Medical University
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Wei Xia
Institute of Reproductive Health, Tongji Medical College, Huazhong University of Science and Technology
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Linai Zhang
Shanxi Maternal and Child Health Hospital
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Yanfei Zhou
Changsha Hospital for Maternal and Child Health Care,
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Yan Zhang
1. NHC Key Lab. of Reproduction Regulation(Shanghai Institute of Planned Parenthood Research), School of Public Health, Fudan University
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Abstract

Objective To explore the prevalence of contraceptive use, unintended pregnancy, and induced abortions within 24 months postpartum in eastern, central, and western regions of China and in China overall. Design A retrospective cohort study. Setting Hospital-based Maternity units. Population Women who delivered a live baby between 12 and 24 months. Methods: We randomly selected postpartum women at 60 hospitals in eastern, central, and western regions of China. We applied descriptive statistics and life-table analyses. Main outcome measures Prevalence of contraception, unintended pregnancy, and abortions. Results: A total of 18,045 participants were enrolled and interviewed, and 12-, and 24-month contraceptive rates were 85.7% (95% CI 85.2-86.2 ), and 86.8% (95% CI 86.3-87.2 ), respectively. Condoms accounted for 79% of contraceptive initiators. The 12-, and 24-month rates were 5.3% (95% CI 5.0-5.6) , and 13.6% (95% CI 12.2-15.0) for unintended pregnancy; and 4.0% (95% CI 3.7-4.3), and 10.8% (95% CI 9.5-12.1) for induced abortion, respectively. Three-quarters of unintended pregnancies ended in abortion. Postpartum contraceptive use was higher in the western region relative to the eastern or central regions, but the risks of unintended pregnancy and induced abortion were also higher in the west. Conclusions: Postpartum contraception use was relatively high in China but dominated by less-effective methods, and these may contribute to higher risks of unintended pregnancy and induced abortion during the postpartum period. Use of long-acting reversible contraceptives and effective and reliable short-acting methods should thus be fostered in postpartum family planning services in China.