Family Planning

The provision of contraception to postabortion clients is a key element of the PAC model. Many PAC clients want and need family planning (FP) and will use contraceptive methods if offered.  The return to fertility after abortion can be rapid (as little as 10 days), and almost all contraceptive methods are suitable for postabortion use.  The provision of postabortion FP services can help women limit and space their pregnancies, prevent subsequent unsafe abortion, and reduce maternal morbidity and mortality.

There is clear evidence that if contraception is offered to women before she leaves the PAC treatment area, uptake of a method will be higher than if she is referred elsewhere for FP counseling.  Integrating FP services with postabortion treatment continues to be challenging; in too many settings contraceptive services are offered in a separate place, by different service providers, and often during limited hours.

General Resources | Training Materials | Studies & Assessments


General Resources

Adding It Up: Costs and Benefits of Contraceptive Services, Estimates for 2012
Susheela Singh and Jacqueline E. Darroch, Guttmacher Institute and UNFPA, 2012
The newest estimates of modern contraceptive use, unmet need, and cost-effectiveness of contraceptive services in all regions of the world are reported in this publication.  Based on the estimates, there has been limited improvement in meeting the need for family planning among women in developing countries.  These findings have implications for reducing unsafe abortion and related maternal mortality, and scale-up of PAC programs.  This document provides recommendations for addressing barriers to contraceptive use by integrating contraceptive services with PAC and other reproductive health programs and working with governments to close existing gaps.

High Impact Practices in Family Planning Brief
USAID, 2013
Provision of family planning services and commodities as part of treatment for incomplete abortion is one of the three proven High Impact Practices for Family Planning identified by USAID. Contraceptive counseling should be offered immediately following treatment and should occur in the same location.

Postabortion Family Planning: Addressing the Cycle of Repeat Unintended Pregnancy and Abortion
Curtis C, Huber D, Moss-Knight T, International Perspectives on Sexual and Reproductive Health, 2010
This article highlights the importance of addressing unmet need for contraceptives during postabortion care. Evidence shows that integrating family planning services with PAC leads to increased uptake of modern contraceptive methods and fewer repeat unintended pregnancies.  The best practices and programmatic recommendations shared in this commentary piece are valuable for policymakers, program managers, and field-based service providers.

Family Planning: A Key Component of Post Abortion Care
FIGO, ICM, ICN, USAID, 2009
This consensus statement affirms the necessity of providing postabortion family planning counseling and services. It is an endorsement of universal access to family planning services during postabortion care.

Training Materials

Email any training materials related to postabortion family planning to info@pac-consortium.org

Studies & Assessments

Contraceptive counseling in Turkey after induced abortion
Gunyeli I, Abike F, Bingol B, Ornek T, 2012
This prospective case-control study measured modern contraceptive uptake among women who presented for induced abortion (<10 weeks gestational age) and controls who sought family planning treatment at the same facilities.  Among women who received postabortion family planning counselling, 85.7% left the facility without a modern contraceptive method compared to 10.9% in the control group. These findings suggest that the family planning of postabortion care in Turkey needs to be strengthened.

The impact of post-abortion care family planning counselling and services in low-income countries: a systematic review of the evidence
Tripney J, Schucan Bird K, Kwan I, Kavanagh J; DFID, 2011
This systematic review includes both published and unpublished literature that measured the effect of postabortion family planning services on maternal mortality, repeat unintended pregnancies, and contraceptive uptake. The findings of this study are inconclusive, but show an overall trend that women who accessed family planning services during postabortion care were more likely to accept or utilize a contraceptive method.  Since unmet need for contraceptives is a key predictor of unintended pregnancies and maternal mortality, the increased uptake of family planning services associated with access to postabortion care family planning services may have significant implications.  This study was limited by the lack of rigorous evaluations and studies about postabortion contraceptive use.

Fertility awareness and family planning use among post abortion women in Egypt
Mahmoud G, Byomy S. (2011). Life Science Journal 10(1): 143-150.
This hospital-based study showed that the majority of women who received abortion services desired to postpone pregnancy, but were not aware of existing contraceptive options and did not plan to use a modern method. One conclusion of this study was that the family planning element of the essential elements of PAC needs to be strengthened in this setting.

Choices on contraceptive methods in post-abortion family planning clinic in the northeast Brazil
A.L. Ferreira; A. Souza; R.A Lima; C.Braga, 2010
A Ministry of Health report in Brazil revealed that a majority of women who underwent an abortion were using a contraceptive method, but mentioned inconsistent or erroneous use. It is know that promoting the use of contraception to prevent unwanted pregnancies is one of the most effective strategies to reduce abortion rates and maternal morbidity and mortality. This study examined the acceptance and selection of contraceptive methods among women who participated in post-abortion family planning counseling.

Situational Analysis of the Integration of Family Planning Services in Postpartum, Postabortion and Prevention of Mother to Child Transmission Programs in the Dominican Republic
CESDEM; Synergy Consulting; Frontiers in Reproductive Health, Population Council, 2008
This analysis assessed the availability of family planning counseling and services during postabortion and postpartum care in the Dominican Republic. Provider and patient knowledge and attitudes in regards to contraceptives and health system capacity were also measured. The authors make key recommendations for improved integration of family planning and postabortion care services.