Contraception, pregnancy, and induced abortion within 24 months of
delivery in eastern, central, and western regions of China: a
retrospective cohort study
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.