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Kapp N, Dijkerman S, Getachew A, Eckersberger E, Pearson E, Abubeker FA, Birara M. Can mid-level providers manage medical abortion after 12 weeks' gestation as safely and effectively as physicians? A non-inferiority, randomized controlled trial in Addis Ababa, Ethiopia. Int J Gynaecol Obstet 2024; 165:1268-1276. [PMID: 38282483 DOI: 10.1002/ijgo.15392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Revised: 08/22/2023] [Accepted: 01/09/2024] [Indexed: 01/30/2024]
Abstract
OBJECTIVE To determine whether clinical outcomes among clients undergoing medical abortion after 12 weeks' gestation differ by provider cadre. METHODS Randomized controlled trial conducted among eligible clients seeking abortion between 13 and 20 weeks' gestation. Participants seeking in-facility abortion were randomized to receive care from a mid-level provider (nurse/midwife) or physician. The primary outcome was median time to expulsion with non-inferiority margin of -1.5 h between provider groups. Quantile median regression models assessed non-inferiority. Secondary outcomes included retained placenta, complications, and patient acceptability. RESULTS After randomization and eligibility assessment by the provider, 171 women participated in the study: 81 in the physician group and 90 in the mid-level provider group. Their average age was 24 years, the mean gestational age was 16 weeks, and 65% were nulliparous in both groups. The median time to expulsion did not differ significantly, being 8.1 h for the mid-level group and 6.6 h for the physician group. The adjusted median difference was 0.8 h (95% confidence interval [CI] -1.15 to 2.66), within the non-inferiority margin. Retained placenta occurred similarly: 30.0% (n = 24) of the physician group and 20.5% (n = 18) of the mid-level provider group (adjusted risk difference [ARD] 7.6%, 95% CI -2.81 to 18.06). Complications occurred in 7% of cases, including 5.0% (n = 4) of patients in the physician group and 8.9% (n = 8) in the mid-level provider group (ARD -4.7%, 95% CI -12.43 to 3.12). Patient acceptability did not differ by group. CONCLUSIONS Training mid-level providers to provide abortion services after 12 weeks' gestation independently of physicians is feasible and may result in comparable clinical outcomes.
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Affiliation(s)
| | | | - Abrham Getachew
- St Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia
| | | | | | - Ferid A Abubeker
- St Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia
| | - Malede Birara
- St Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia
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Liu H, Wu F, Liao G, Mai S, Ouyang M. Impact of the intensive psychological intervention care on post-traumatic stress disorder and negative emotions of teenage female patients seeking an induced abortion. Front Psychiatry 2023; 14:1033320. [PMID: 37900292 PMCID: PMC10602776 DOI: 10.3389/fpsyt.2023.1033320] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Accepted: 09/28/2023] [Indexed: 10/31/2023] Open
Abstract
Aim This study aimed to investigate the effects of intensive psychological intervention care on adverse emotions and post-traumatic stress disorder (PTSD) symptoms in female teenage patients after induced abortion. Methods This prospective cohort study included 100 teenage female patients seeking induced abortion who were randomly divided into two groups: the intervention group (n = 50) and the control group (n = 50). The intervention group received intensive psychological intervention care, while the control group received standard routine nursing. The scores of the PTSD checklist for DSM-5 (PCL-5), self-rating depression (SDS), and self-rating anxiety scale (SAS) were compared between the two groups at 1 month and 3 months after the operation. Results The intervention group had lower risk of developing PTSD (24% vs. 44%), depression (10% vs. 32%), and anxiety (0% vs. 12%) symptoms at 1 month after the surgery. However, there were no significant differences observed between the two groups at 3 months after the surgery. Furthermore, the intervention group had significantly lower scores in PCL-5 (27.4 ± 5.4 vs. 31.8 ± 5.7; 20.5 ± 7.1 vs. 25.0 ± 7.5; p < 0.05), SDS (31.8 ± 5.4 vs. 37.8 ± 6.6; 26.8 ± 5.0 vs. 31.4 ± 7.2; p < 0.05), and SAS (32.7 ± 5.0 vs. 39.8 ± 6.9; 25.0 ± 2.7 vs. 27.5 ± 2.8; p < 0.05) at 1 month and 3 months after induced abortion. Conclusion These findings suggest that intensive psychological intervention care can reduce the incidence and severity of depression, anxiety, and PTSD symptoms in teenage patients who undergo induced abortion. Clinical trial registration https://www.chictr.org.cn/showproj.html?proj=185200, identifier ChiCTR2300067531.
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Affiliation(s)
- Huiling Liu
- Department of Gynecology, Shunde Hospital, Southern Medical University (The First People’s Hospital of Shunde), Foshan, China
| | - Fengdi Wu
- Department of Gynecology, Shunde Hospital, Southern Medical University (The First People’s Hospital of Shunde), Foshan, China
| | - Guixia Liao
- Nursing Department, Shunde Hospital, Southern Medical University (The First People’s Hospital of Shunde), Foshan, China
| | - Sizi Mai
- Department of Clinical Psychology, Shunde Hospital, Southern Medical University (The First People’s Hospital of Shunde), Foshan, China
| | - Meijin Ouyang
- Department of Gynecology, Shunde Hospital, Southern Medical University (The First People’s Hospital of Shunde), Foshan, China
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Quak XES, Sultana R, Aau WK, Goh CC, Tan NC. A 3-year retrospective study of unintended pregnancy in a developed multi-ethnic Asian community: A call for better healthcare system for family planning. Front Public Health 2022; 10:996696. [PMID: 36504963 PMCID: PMC9727312 DOI: 10.3389/fpubh.2022.996696] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Accepted: 11/01/2022] [Indexed: 11/24/2022] Open
Abstract
Background Women of childbearing age may face unintended pregnancy (UP). They are usually referred by primary care professionals (PCPs) to gynecologists to manage their UP in countries where abortion is legalized. The study aimed to determine the prevalence, demographic profiles, and associated factors of women in a developed community seeking referrals from PCPs for their UP. Methods The sociodemographic and clinical data were extracted from the electronic medical records of pregnant multi-ethnic Asian women at eight Singapore public primary care clinics from July 2017 to June 2020. Their demographic profiles were reviewed and compared among women of different age bands using appropriate statistical tests. Logistic regression was used to identify the factors associated with UP referrals. Results Among 9,794 gravid women, 974 of them requested gynecologist referrals to terminate UP over the 3-year period, constituting a prevalence of 9.94%. The mean age of women requesting such referrals was 29.7 ± 7 years. There were 10.7% with more than one prior unintended pregnancy and 15.7% were foreigners. The majority of these women were married, neither required social assistance nor had comorbidities. Only 2.9% of them were known to be prescribed contraceptives. A multivariable logistic regression analysis showed that women of Indian ethnicity, single, aged below 20 years and above 40 years, were more likely to request referrals for UP. Conclusion One in 10 gravid women had sought referrals for UP, especially adolescents and older women, and Indian ethnicity. An accessible community-based healthcare service to educate and counsel women on family planning is urgently needed to reduce the incidence of UP.
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Affiliation(s)
| | | | | | | | - Ngiap Chuan Tan
- SingHealth Polyclinics, Singapore, Singapore,SingHealth-Duke NUS Family Medicine Academic Clinical Program, Singapore, Singapore,*Correspondence: Ngiap Chuan Tan
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Fessehaye A, Lucero-Prisno DE, Wondafrash M, Tolu LB, Asrat M. Late Request for Safe Abortion Care at a Tertiary Hospital in Ethiopia; the role of emotional factors: A Cross-Sectional Study. Int J Gynaecol Obstet 2021; 158:462-468. [PMID: 34888867 DOI: 10.1002/ijgo.14065] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Revised: 11/13/2021] [Accepted: 12/08/2021] [Indexed: 11/10/2022]
Abstract
OBJECTIVE To determine the prevalence of second trimester safe abortion and to examine it's association with emotional and interpersonal factors. METHODS We conducted a cross-sectional study on second-trimester pregnant women who requested for safe abortion care from June 2020 to December 2020 at St.Pauls Hospital Millennium Medical College. Data was collected using the interviewer-administered questionnaire on Open Data Kit (ODK) and analyzed using STATA release 15 (College Station, TX: StataCorp LLC). Variables with P value < 0.2 on bivariate analysis were entered for multivariable regression analysis. RESULTS The prevalence of induced second-trimester abortion in our study is found to be 64%. Women who had no emotional factors, who had no inter-personal problems, who were married , and who had middle and high income were less likely to present in second trimester for safe abortion care [( AOR=0.31, 95th CI 0.15-0.67), (AOR=0.55, 95th CI 0.32-0.92), (AOR=0.37, 95th CI 0.17-0.77) and (AOR=0.51, CI0.27-0.96) respectively]. CONCLUSION Sixty-four percent of safe abortion care clients in our study presented in second trimester . Emotional factors, interpersonal factors, being married and middle/high income were significantly associated with reduced risk of late request (presentation in second trimester) for safe abortion care.
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Affiliation(s)
- Abraham Fessehaye
- Department of Obstetrics and Gynecology, St.Paul's Millennium Medical College (SPHMMC), Addis Ababa, Ethiopia
| | - Don Eliseo Lucero-Prisno
- Department of Global Health and Development, London School of Hygiene and Tropical Medicine, United Kingdom.,Faculty of Management and Development Studies, University of the Philippines (Open University), Los Baños, Laguna, Philippines
| | - Mekitie Wondafrash
- St. Paul's Institute for Reproductive Health and Rights, Addis Ababa, Ethiopia
| | - Lemi Belay Tolu
- Department of Obstetrics and Gynecology, St.Paul's Millennium Medical College (SPHMMC), Addis Ababa, Ethiopia
| | - Matias Asrat
- Department of Obstetrics and Gynecology, St.Paul's Millennium Medical College (SPHMMC), Addis Ababa, Ethiopia
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Low V, Choo SN, Huang Z. Reasons for termination of pregnancy in mid-trimester: A single-centre experience. ANNALS OF THE ACADEMY OF MEDICINE, SINGAPORE 2021; 50:343-345. [PMID: 33990823 DOI: 10.47102/annals-acadmedsg.2020607] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Affiliation(s)
- Valerie Low
- Department of Obstetrics and Gynaecology, National University Hospital, Singapore
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Kapp N, Andersen K, Griffin R, Handayani AP, Schellekens M, Gomperts R. Medical abortion at 13 or more weeks gestation provided through telemedicine: A retrospective review of services. Contracept X 2021; 3:100057. [PMID: 33615210 PMCID: PMC7881210 DOI: 10.1016/j.conx.2021.100057] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Revised: 01/15/2021] [Accepted: 01/20/2021] [Indexed: 11/24/2022] Open
Abstract
Objectives To evaluate medical abortion effectiveness and safety in women at 13 or more weeks gestation provided care through Women on Web's telemedicine service. Study Design We conducted a retrospective case study of abortions at 13 or more weeks gestation provided by Women on Web between 2016 and 2019. Women received mifepristone and misoprostol or misoprostol alone for abortion. We extracted demographic characteristics and outcome data for cases with pregnancy continuation outcomes. Results We identified 144 women who used medical abortion at 13 or more weeks; 131 (91%) provided abortion outcome data. Almost all, 118 (90%) received mifepristone and misoprostol. The population had an average age of 26 ± 5.8 years, 102 (78%) reported a gestational age of 13 to 15 weeks, 114 (87%) had experienced prior pregnancy, and represented all world regions. Overall, 13 (10%) women reported a continuing pregnancy, with 5 (5%) among women 13 to 15 weeks and 8 (28%) among those ≥16 weeks (p = 0.001); 38 (29%) reported adverse events (heavy bleeding, fever), 53 (43%) sought additional care from a health provider, and 18% of all cases received treatment with D&C/aspiration. Conclusions Efficacy of self-administered medical abortion decreases as gestational age increases, risking continuation of pregnancy. Provision through telemedicine at 13 to 15 weeks appears safe and effective. Implications Limited data suggest that medical abortion through telemedicine services may be a safe option through 15 weeks gestation in settings where there is ready access to the formal health system. More research with adequate sample sizes and high rates of follow-up is needed to inform on the safety of telemedicine for pregnancies 13 weeks and greater.
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Le Lous M, Coulais C, Boyer L, Denoel S, Leveque J, Nyangoh Timoh K, Lavoue V. Who are the minors seeking an abortion for an unplanned pregnancy? A French observational study. J Gynecol Obstet Hum Reprod 2019; 48:643-647. [DOI: 10.1016/j.jogoh.2019.04.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2019] [Revised: 04/05/2019] [Accepted: 04/09/2019] [Indexed: 11/25/2022]
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Factors Influencing Abortion Decision-Making Processes among Young Women. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15020329. [PMID: 29438335 PMCID: PMC5858398 DOI: 10.3390/ijerph15020329] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/29/2017] [Revised: 02/10/2018] [Accepted: 02/11/2018] [Indexed: 11/17/2022]
Abstract
Background: Decision-making about if and how to terminate a pregnancy is a dilemma for young women experiencing an unwanted pregnancy. Those women are subject to sociocultural and economic barriers that limit their autonomy and make them vulnerable to pressures that influence or force decisions about abortion. Objective: The objective of this study was to explore the individual, interpersonal and environmental factors behind the abortion decision-making process among young Mozambican women. Methods: A qualitative study was conducted in Maputo and Quelimane. Participants were identified during a cross-sectional survey with women in the reproductive age (15–49). In total, 14 women aged 15 to 24 who had had an abortion participated in in-depth interviews. A thematic analysis was used. Results: The study found determinants at different levels, including the low degree of autonomy for women, the limited availability of health facilities providing abortion services and a lack of patient-centeredness of health services. Conclusions: Based on the results of the study, the authors suggest strategies to increase knowledge of abortion rights and services and to improve the quality and accessibility of abortion services in Mozambique.
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Pereira J, Pires R, Araújo Pedrosa A, Vicente L, Bombas T, Canavarro MC. Sociodemographic, sexual, reproductive and relationship characteristics of adolescents having an abortion in Portugal: a homogeneous or a heterogeneous group? EUR J CONTRACEP REPR 2016; 22:53-61. [PMID: 27960606 DOI: 10.1080/13625187.2016.1266323] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVES The aims of the study were to describe the sociodemographic, sexual, reproductive and relational characteristics of adolescents having an abortion in Portugal and to explore the differences between three adolescent age groups. METHODS We recruited a nationally representative sample of 224 adolescents (<16 years, n = 18; 16-17 years, n = 103; 18-19 years, n = 103) who had an abortion. Data were collected from 16 health care services that provide abortion. RESULTS The adolescents were predominantly single, were from non-nuclear families, had low-socioeconomic status and were students. Mean age at first sexual intercourse was 15 years and mean gynaecological age was 5 years. Most had had multiple sexual partners, and for most it was their first pregnancy. At conception, the majority were involved in a long-term romantic relationship, were using contraception but did not identify the contraceptive failure that led to the pregnancy. Significant age group differences were found. Compared with the younger age groups, the 18-19 year age group was more frequently married or living with a partner, had finished school, had attained a higher educational level (as had their partner), intended to go to university, and had a greater number of sexual partners. Compared with the other groups, those under 16 years of age reported earlier age at menarche and at first sexual intercourse, and had a lower gynaecological age. CONCLUSIONS Our study characterises the life contexts of Portuguese adolescents who had an abortion. It highlights the need to recognise the heterogeneity of this group according to age. The findings have important implications for the development of age-appropriate guidelines to prevent unplanned pregnancy.
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Affiliation(s)
- Joana Pereira
- a Faculty of Psychology and Educational Sciences , Cognitive-Behavioural Research Centre (CINEICC), University of Coimbra , Coimbra , Portugal.,b Psychological Intervention Unit , Daniel de Matos Maternity Hospital, Coimbra University Hospitals (CHUC EPE) , Coimbra , Portugal
| | - Raquel Pires
- a Faculty of Psychology and Educational Sciences , Cognitive-Behavioural Research Centre (CINEICC), University of Coimbra , Coimbra , Portugal.,c School of Psychology and Life Sciences, Lusófona University of Humanities and Technology , Lisbon , Portugal
| | - Anabela Araújo Pedrosa
- b Psychological Intervention Unit , Daniel de Matos Maternity Hospital, Coimbra University Hospitals (CHUC EPE) , Coimbra , Portugal
| | - Lisa Vicente
- d Division of Infant, Youth, Reproductive and Sexual Health , Directorate-General of Health , Lisbon , Portugal
| | - Teresa Bombas
- e Obstetric Service , Coimbra University Hospitals (CHUC EPE) , Coimbra , Portugal
| | - Maria Cristina Canavarro
- a Faculty of Psychology and Educational Sciences , Cognitive-Behavioural Research Centre (CINEICC), University of Coimbra , Coimbra , Portugal.,b Psychological Intervention Unit , Daniel de Matos Maternity Hospital, Coimbra University Hospitals (CHUC EPE) , Coimbra , Portugal
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Gosavi A, Ma Y, Wong H, Singh K. Knowledge and factors determining choice of contraception among Singaporean women. Singapore Med J 2016; 57:610-615. [PMID: 26762287 DOI: 10.11622/smedj.2015181] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
INTRODUCTION The study aimed to assess the level of awareness and knowledge of contraception among women in Singapore, and identify the factors that influence contraception choice. METHODS We conducted a cross-sectional survey of 259 female patients, aged 21-49 years, who attended the Obstetrics and Gynaecology Clinic at National University Hospital, Singapore. An original questionnaire on nine contraceptive methods was used. Respondents who had ≥ 2 correct answers for a method (out of four questions) were considered to have good knowledge of the method. Participants were asked to rate factors known to influence contraceptive choice as important or not important. RESULTS Awareness of the following methods was high: condom (100.0%), oral contraception pill (89.2%), tubal ligation (73.0%) and copper intrauterine device (IUD) (72.2%). The women were least aware of hormonal IUD (24.3%). Women who were parous, had a previous abortion, had completed their family or used contraception previously were more likely to have a higher awareness of contraception. 89.2% of the women had good knowledge of the condom; among those aware of hormonal IUD, only 46.0% had good knowledge of it. Women who had used hormonal IUD and the condom were more likely to have good knowledge of them. Many rated efficacy (90.5%) and a healthcare professional's advice (90.1%) as important in contraceptive choice. Few considered peer influence (21.0%) and cultural practices (16.3%) to be important. CONCLUSION Women in Singapore have poor awareness and knowledge of contraception, especially long-acting reversible methods. More effective ways are needed to educate women about contraceptive methods.
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Affiliation(s)
- Arundhati Gosavi
- Department of Obstetrics and Gynaecology, National University Hospital, Singapore
| | - Yueyun Ma
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Hungchew Wong
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Kuldip Singh
- Department of Obstetrics and Gynaecology, National University Hospital, Singapore
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Cameron ST, Riddell J, Brown A, Thomson A, Melville C, Flett G, Caird L, Laird G. Characteristics of women who present for abortion towards the end of the mid-trimester in Scotland: national audit 2013-2014. EUR J CONTRACEP REPR 2015; 21:183-8. [PMID: 26568404 DOI: 10.3109/13625187.2015.1111326] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
OBJECTIVES Women in Scotland who request an abortion (for non-medical reasons) within the legal gestational limit (up to 24 weeks) but beyond the gestational limit of all abortion facilities in Scotland (only up to 20 weeks) must travel to England if they wish to terminate the pregnancy. We wished to determine the number and characteristics of women presenting at ≥16 weeks' gestation for abortion, and compare the characteristics of those proceeding to abortion with those continuing the pregnancy. METHODS Over a period of 12 months we conducted a prospective audit of women presenting at ≥16 weeks' gestation to abortion services throughout Scotland. The characteristics of women proceeding to abortion and those continuing the pregnancy were compared. RESULTS A total of 267 women presented for abortion at ≥16 weeks' gestation. Their median age was 22 years (range 14 to 47 years); 231 were from deprived areas (86.5%), 128 (47.9%) already had a child and 73 (27.3%) had previously undergone abortion. A total of 175 women (65.5%) proceeded to abortion, locally (n = 125; 46.8%) or in England (50; 18.7%). Those at ≥20 weeks' gestation were statistically more likely to continue the pregnancy than those at earlier gestations (p < 0.001). CONCLUSIONS Relatively few women present for abortion in Scotland at ≥16 weeks' gestation. Those who are over 20 weeks' gestation and would need to travel to England for abortion are more likely to continue the pregnancy, suggesting that travel is a barrier to accessing legal abortion for this group of women. Provision of abortion services up to 24 weeks' gestation should be considered within Scotland.
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Affiliation(s)
| | | | | | | | | | | | - Lucy Caird
- f NHS Highland , Inverness , Scotland, UK
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Abstract
OBJECTIVE To determine whether demographic or patient factors contribute to later presentation (10 to 12 weeks' gestational age) for induced abortion in a Canadian abortion clinic. METHODS Women attending a hospital-based abortion clinic between April and September 2012 were asked to complete a survey. The characteristics of women who presented early (EPs; gestational age < 10 weeks) were compared with those of late presenters (LPs; gestational age ≥ 10 weeks) using t tests for means and Fisher exact tests for rates. RESULTS Among women referred to the clinic by a primary care provider, LPs were more likely than EPs to report "a delay in obtaining a referral" (20.8% vs. 6.1%; P = 0.007). While there was no significant difference between the groups in reporting that "someone tried to discourage [them] from having an abortion" (26.45% for EPs, 32.4% for LPs; P = 0.421), LPs were more likely to report that discouragement "caused a delay in making arrangements" (45.5% vs. 16.7%; P = 0.019). Of women who had access to a primary care provider, it was more common for the primary care provider to be aware of the pregnancy among LPs than among EPs (80.6% vs. 63.1%; P = 0.015). CONCLUSION Some women delay presenting for abortion because of discouragement from friends and family. It is unclear whether there are educational or policy interventions that can have an impact on this delay, and this warrants further study. There may be ways of addressing the delay in referral by primary care providers. Further study into the causes for delay in referral for abortion is warranted.
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Zhang WH, Che Y, Chen Q, Cheng L, Temmerman M. Contraception interventions for women seeking abortion. Hippokratia 2014. [DOI: 10.1002/14651858.cd011067] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Wei-Hong Zhang
- Université Libre de Bruxelles; School of Public Health; 808, Route de Lennik, CP 592 Brussels Belgium 1070
| | - Yan Che
- Shanghai Institute of Planned Parenthood Research (SIPPR); Centre for Clinical Research and Training; 2140 Xie Tu Road Shanghai China 200032
| | - Qiuju Chen
- Ghent University; Center for Reproductive Health; Gent Belgium
| | - Linan Cheng
- Shanghai Institute of Planned Parenthood Research (SIPPR); Centre for Clinical Research and Training; 2140 Xie Tu Road Shanghai China 200032
| | - Marleen Temmerman
- World Health Organization; Department of Reproductive Health and Research; 20 Via Appia Geneva Switzerland 1211
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