Post‐abortion contraception before hospital discharge after installation of a surveillance network in Brazil

Post‐abortion contraception before hospital discharge after installation of a surveillance network in Brazil

Objective To evaluate the use of contraception soon after abortion, ectopic, or molar pregnancy following the establishment of a surveillance network (MUSA). Methods A cross‐sectional study of women admitted for abortion, or ectopic or molar pregnancy at UNICAMP Women's Hospital (part of the MU...

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Published in:International journal of gynecology and obstetrics Vol. 150; no. 2; pp. 200 - 205
Main Authors: Veiga‐Junior, Nelio N., Cavalari, Camila A., Eugeni, Caroline, Kajiura, Beatriz D., Stefano, Natalia, Baccaro, Luiz F.
Format: Journal Article
Language:English
Published: United States 01-08-2020
Subjects:
Ambulatory care facilities
CLAP MUSA network
Contraceptive effectiveness
Health surveys
Perinatal information system
Population surveillance
Sentinel surveillance
SIP
CLAP MUSA network
Sentinel surveillance
Population surveillance
SIP
Ambulatory care facilities
Health surveys
Perinatal information system
Contraceptive effectiveness
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Summary:Objective To evaluate the use of contraception soon after abortion, ectopic, or molar pregnancy following the establishment of a surveillance network (MUSA). Methods A cross‐sectional study of women admitted for abortion, or ectopic or molar pregnancy at UNICAMP Women's Hospital (part of the MUSA Network), Campinas, Brazil, between July 2017 and August 2019. Clinical and sociodemographic data were compared between women who initiated contraception before discharge and those who did not by using a Cochran‐Armitage test and multiple logistic regression. Results Overall, 382 women were enrolled (mean ± SD age, 29.6 ± 7.4 years). Most women (287, 75.2%) had abortions, and 146 (38.2%) initiated contraception before hospital discharge. The most common contraceptives were injectables (75, 51.4%) followed by pills (65, 44.5%). Use of contraception increased during the study period (Z=3.69, P<0.01), mostly due to injectables (Z=3.84, P<0.01). Factors independently associated with contraceptive initiation were admission in 2019 (odds ratio [OR], 2.65; 95% confidence interval [CI], 1.36–5.17) and not having an abortion for legal reasons (OR, 3.54; 95% CI, 1.30–9.62). Conclusion Implementation of a surveillance network optimized the health service and quality of care. There was an increase in contraception use and a vulnerable population was identified. Installation of a low‐cost surveillance network (MUSA Network) for clinical practice has strengthened access to post‐abortion contraception at a general hospital in Brazil.
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ISSN:0020-7292
1879-3479
DOI:10.1002/ijgo.13170