Pregnancy termination and contraceptive failure in Viet Nam

In Viet Nam, health workers conducted focus groups with women seeking pregnancy termination at 2 rural district hospitals in Thai Binh Province and at 2 urban district hospitals in Hanoi to learn why contraceptives failed and why some of these women did not use contraceptive. Researchers used information from the focus groups to design questions for a July-September 1991 survey of 2088 women seeking an abortion at all 9 rural district hospitals in Thai Binh Province and at 5 district hospitals in Hanoi. 85.3% of the women were married and lived with their husbands. Most women were eligible for menstrual regulation (53.7% in Hanoi and 64.9% in Thai Binh). 50% of all women (52.8% in Hanoi and 47.4% in Thai Binh) had had at last 1 prior pregnancy termination (1.6 pregnancy terminations/woman), suggesting that induced abortion is being used as a substitute for family planning methods. Effective modern contraceptive use by 50% of these women would have reduced the number of abortions during the 3 months by 25%. 36.8% (54.7% in Hanoi and 19.9% in Thai Binh) used traditional family planning methods. 38.3% (25.7% in Hanoi and 49.9% in Thai Binh) did not use any method. The leading reason for not using oral contraceptives (OCs) were personal health problems, unavailability, and the perception that contraceptives were bad for one's health. For IUDs, they were bleeding, lumbago, headache, loss of energy, and dizziness. For condoms, reasons for nonuse were disliked by one spouse and unavailability. Women's fear and husband's disapproval were key reasons for not choosing sexual sterilization. Reasons for failure of condoms, IUDs, and OCs were irregular use (62.6%) and poor quality (27.9), retained but still missed menstruation (74.3%), and used irregularly (23/28), respectively. The researchers recommended using these findings to develop an IEC campaign and training curricula for health workers.