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Postpartum and post-abortion contraceptive use among unmarried young women in Ghana

Published online by Cambridge University Press:  29 June 2020

D. Yaw Atiglo Open the ORCID record for D. Yaw Atiglo [Opens in a new window]  and
Adriana A. E. Biney Open the ORCID record for Adriana A. E. Biney [Opens in a new window]
D. Yaw Atiglo*
Affiliation:
Regional Institute for Population Studies, University of Ghana
Adriana A. E. Biney
Affiliation:
Regional Institute for Population Studies, University of Ghana
*
*Corresponding author. Email: [email protected]
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Abstract

Pregnancy outcomes impact subsequent contraceptive behaviour. The purpose of this study was to assess the relationship between previous pregnancy outcomes and subsequent contraceptive behaviours among unmarried young women intending to delay childbearing. Using data from the 2014 Ghana Demographic and Health Survey, among 1118 sexually experienced, fecund and non-pregnant unmarried women aged 15–24 years, the study assessed how childbirth and abortion are related to sexual abstinence and use of modern contraception. While about 70% of unmarried young women were nulligravid, approximately 11% had had an abortion and 18.2% were postpartum. The majority of respondents were sexually abstinent while 21% and 27% were using and not using contraception, respectively. Postpartum women were more likely than nulligravid and post-abortion women to use contraceptives. Post-abortion women were least likely to be sexually abstinent. Number of years since the respondent’s sexual debut was positively associated with the likelihood of using modern contraception, particularly among postpartum women, and negatively associated with sexual abstinence among those who had aborted. The findings show that prior pregnancy outcomes have significant implications for secondary abstinence and contraceptive use among unmarried young women in Ghana. Post-abortion women are more likely than postpartum women to be sexually active but less likely to use contraceptives. Efforts must be strengthened towards increasing access to modern contraceptives for young women who present for abortion in Ghana.

Keywords

Post-abortion contraceptionSexual abstinenceYoung adults
Type
Research Article
Information
Journal of Biosocial Science , Volume 53 , Issue 3 , May 2021 , pp. 459 - 470
Copyright
© The Author(s), 2020. Published by Cambridge University Press

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References

Agyei, WK, Biritwum, RB, Ashitey, A and Hill, RB (2000) Sexual behaviour and contraception among unmarried adolescents and young adults in Greater Accra and Eastern Regions of Ghana. Journal of Biosocial Science 32, 495–512.CrossRefGoogle Scholar
Alhassan, N and Dodoo, FNA (2020) Predictors of primary and secondary sexual abstinence among never-married youth in urban poor Accra, Ghana. Reproductive Health 17(1), 28.CrossRefGoogle ScholarPubMed
Atiglo, DY and Biney, AAE (2018) Correlates of sexual inactivity and met need for contraceptives among young women in Ghana. BMC Women’s Health 18(139), doi: 10.1186/s12905-018-0630-0 CrossRefGoogle ScholarPubMed
Atiglo, DY and Codjoe, SNA (2019) Meeting women’s demand for contraceptives in Ghana: does autonomy matter? Women & Health 59(4), 347–363.CrossRefGoogle ScholarPubMed
Awusabo-Asare, K, Abane, AM and Kumi-Kyereme, A (2004) Adolescent Sexual and Reproductive Health in Ghana: A Synthesis of Research Evidence. The Alan Guttmacher Institute, New York.Google Scholar
Banerjee, SK, Gulati, S, Andersen, KL, Acre, V, Warvadekar, J and Navin, D (2015) Associations between abortion services and acceptance of postabortion contraception in six Indian states. Studies in Family Planning 46(4), 387–403.CrossRefGoogle ScholarPubMed
Biney, AAE (2011) Exploring contraceptive knowledge and use among women experiencing induced abortion in the Greater Accra Region, Ghana. African Journal of Reproductive Health 15(1), 37–46.Google ScholarPubMed
Biney, AAE and Atiglo, DY (2017) Examining the association between motivations for induced abortion and method safety among women in Ghana. Women & Health 57(9), 1044–1060.CrossRefGoogle ScholarPubMed
Biney, AAE and Nyarko, P (2017) Is a woman’s first pregnancy outcome related to her years of schooling? An assessment of women’s adolescent pregnancy outcomes and subsequent educational attainment in Ghana. Reproductive Health 14(123), 1–15.CrossRefGoogle ScholarPubMed
Chandra-Mouli, V, McCarraher, DR, Phillips, SJ, Williamson, NE and Hainsworth, G (2014) Contraception for adolescents in low and middle income countries: needs, barriers, and access. Reproductive Health 11(1). doi: 10.1186/1742-4755-11-1 CrossRefGoogle ScholarPubMed
Chernick, LS, Schnall, R, Higgins, T, Stockwell, MS, Castaño, PM, Santelli, J and Dayan, PS (2015) Barriers to and enablers of contraceptive use among adolescent females and their interest in an emergency department based intervention. Contraception 91(3), 217–225.CrossRefGoogle Scholar
Cockrill, K and Nack, A (2013) “I’m not that type of person”: managing the stigma of having an abortion. Deviant Behaviour 34(12), 973–990.CrossRefGoogle Scholar
Cwiak, C, Howard, B, Hsieh, J, Ricciotti, N and Sucato, GS (2016) Sexual and contraceptive behaviors among adolescents requesting emergency contraception. Journal of Pediatric and Adolescent Gynecology 29(6), 643–647.CrossRefGoogle ScholarPubMed
Festin, MPR, Kiarie, J, Solo, J, Spieler, J, Malarcher, S, Van Look, PFA and Temmerman, M (2016) Moving towards the goals of FP2020 – classifying contraceptives. Contraception 94(4), 289–294.CrossRefGoogle ScholarPubMed
GSS, GHS and ICF International (2015) Ghana Demographic and Health Survey 2014. Ghana Statistical Service Ghana Health Service and ICF International, Rockville, MD, USA.Google Scholar
Hall, KS, Manu, A, Morhe, E, Dalton, VK, Loll, D, Dozier, JL et al. (2018) Bad girl and unmet family planning need among Sub-Saharan African adolescents: the role of sexual and reproductive health stigma. Qualitative Research in Medicine & Healthcare 2(1), 55–64.CrossRefGoogle ScholarPubMed
Hindin, MJ, Kalamar, AM, Thompson, TA and Upadhyay, UD (2016) Interventions to prevent unintended and repeat pregnancy among young people in low- and middle-income countries: a systematic review of the published and gray literature. Journal of Adolescent Health 59(3), S8–S15.CrossRefGoogle ScholarPubMed
Hindin, MJ, McGough, LJ and Adanu, RM (2014) Misperceptions, misinformation and myths about modern contraceptive use in Ghana. Journal of Family Planning and Reproductive Health Care 40(1), 30–35.CrossRefGoogle ScholarPubMed
Hubacher, D and Trussell, J (2015) A definition of modern contraceptive methods. Contraception 92(5), 420–421.CrossRefGoogle ScholarPubMed
Loewenson, PR, Ireland, M and Resnick, MD (2004) Primary and secondary sexual abstinence in high school students. Journal of Adolescent Health 34(3), 209–215.CrossRefGoogle ScholarPubMed
Machiyama, K and Cleland, J (2014) Unmet need for family planning in Ghana: the shifting contributions of lack of access and attitudinal resistance. Studies in Family Planning 45, 203–226.CrossRefGoogle ScholarPubMed
Magnusson, BM, Masho, SW and Lapane, KL (2012) Early age at first intercourse and subsequent gaps in contraceptive use. Journal of Women’s Health 21(1), 73–79.CrossRefGoogle ScholarPubMed
Maravilla, JC, Betts, KS, Abajobir, AA, Couto e Cruz, C and Alati, R (2016) The role of community health workers in preventing adolescent repeat pregnancies and births. Journal of Adolescent Health 59(4), 378–390.CrossRefGoogle ScholarPubMed
Mirembe, F, Karanja, J, Hassan, EO and Faúndes, A (2010) Goals and activities proposed by countries in seven regions of the world toward prevention of unsafe abortion. International Journal of Gynecology and Obstetrics 110(Supplement), S25–S29.CrossRefGoogle ScholarPubMed
Mosher, W, Jones, J and Abma, J (2015) Nonuse of contraception among women at risk of unintended pregnancy in the United States. Contraception 92(2), 170–176.CrossRefGoogle ScholarPubMed
Nyarko, SH (2015) Prevalence and correlates of contraceptive use among female adolescents in Ghana. BMC Women’s Health 15(60), doi: http://doi.org/10.1186/s12905-015-0221-2 CrossRefGoogle ScholarPubMed
Osei, FI, Mayhew, SH, Biekro, L, Collumbien, M and ECAF-Team (2014) Fertility decisions and contraceptive use at different stages of relationships: windows of risk among men and women in Accra. International Perspectives on Sexual and Reproductive Health 40(3), 135–143.CrossRefGoogle ScholarPubMed
Padmadas, SS, Lyons-Amos, M and Thapa, S (2014) Contraceptive behavior among women after abortion in Nepal. International Journal of Gynecology and Obstetrics 127(2), 132–137.CrossRefGoogle ScholarPubMed
Payne, CM, Debbink, MP, Steele, EA, Buck, CT, Martin, LA, Hassinger, JA and Harris, LH (2013) Why women are dying from unsafe abortion: narratives of Ghanaian abortion providers. African Journal of Reproductive Health 17, 118–128.Google ScholarPubMed
Rossier, C (2003) Induced abortion rates: estimating a review. Studies in Family Planning 34(2), 87–102.CrossRefGoogle ScholarPubMed
Shah, I and Ahman, E (2010) Unsafe abortion in 2008: global and regional levels and trends. Reproductive Health Matters 18(36), 90–101.CrossRefGoogle ScholarPubMed
Shah, IH, Santhya, KG and Cleland, J (2015) Postpartum and post-abortion contraception: from research to programs. Studies in Family Planning 46(4), 343–353.CrossRefGoogle ScholarPubMed
Sundaram, A, Juarez, F, Bankole, A and Singh, S (2012) Factors associated with abortion-seeking and obtaining a safe abortion in Ghana. Studies in Family Planning 43(4), 273–286.CrossRefGoogle ScholarPubMed
Tripney, J, Kwan, I and Bird, KS (2013) Postabortion family planning counseling and services for women in low-income countries: a systematic review. Contraception 87(1), 17–25.CrossRefGoogle ScholarPubMed
Vasilenko, SA, Lefkowitz, ES and Welsh, DP (2014) Is sexual behavior healthy for adolescents? A conceptual framework for research on adolescent sexual behavior and physical, mental, and social health. New Directions for Child and Adolescent Development 2014(144), 3–19.CrossRefGoogle ScholarPubMed
Wilson, EK, Fowler, CI and Koo, HP (2013) Postpartum contraceptive use among adolescent mothers in seven states. Journal of Adolescent Health 52(3), 278–283.CrossRefGoogle ScholarPubMed
Wulifan, JK, Brenner, S, Jahn, A and De Allegri, M (2016) A scoping review on determinants of unmet need for family planning among women of reproductive age in low and middle income countries. BMC Women’s Health 16(1), 2.CrossRefGoogle ScholarPubMed
Zaba, B, Pisani, E, Slaymaker, E and Boerma, JT (2004) Age at first sex: understanding recent trends in African demographic surveys. Sexually Transmitted Infections 80(Supplement 2), ii28–35.CrossRefGoogle ScholarPubMed