Acceptance of post-abortion contraception following unsupervised intake of abortion pills at tertiary care teaching institute: an eye opener

Background: Women opting for unsupervised abortion pill intake over contraceptive measures shows a lack of awareness about the effectiveness of family planning methods. There is an urgent need to promote awareness and acceptance of various family planning methods. There is an urgent need to promote awareness and acceptance of various family planning methods, especially by the survivors of adverse consequences of over-the-counter use of medical termination of pregnancy (MTP) pills. Methods: The prospective study was conducted at the obstetrics and gynecology department of Rajendra Institute of Medical Sciences, Ranchi from June 2020 to October 2021. Out of 98 patients reported after unsupervised intake of MTP pills, with complications. 56 patients opted for various methods of family planning, post-abortion after counselling Statistical analysis was done using statistical package for the social sciences (SPSS) 20.0 software, and results were calculated. Results: Out of 56 patients, the majority were educated, and had education up to primary, matriculation, and above matriculation with 23.21%, 28.57%, and 26.79% respectively. Most of the women belonged to upper- lower class (50%). 53.17% took pills at gestation age between 7 weeks to 12 weeks. the majority had an incomplete abortion (69.64%) with stable vitals. 1 case of uterine perforation, 4 cases of rupture ectopics, and 2 cases of chronic ectopic pregnancy were also reported. Most patients opted for DMPA injectables (44.64%). 23.14% chose other methods of family planning such as barriers, patches, and vaginal rings. 4 women opted for intrauterine contraceptive device (IUCD), 5 accepted the use of oral contraceptive pills (OCP) and 9 cases went for permanent female sterilization. Conclusions: Gynecologists and obstetricians have an ethical obligation to ensure that post-abortion contraception, becomes an integral part of abortion and post-abortion care, in view with the recommendations of the International Federation of Gynaecology and Obstetrics and several other organizations. Government needs to take steps to enforce the adoption of various contraceptive methods, thereby decreasing the incidence of unsafe abortion and maternal mortality.