{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,13]],"date-time":"2026-02-13T10:24:18Z","timestamp":1770978258616,"version":"3.50.1"},"reference-count":25,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2014,7,5]],"date-time":"2014-07-05T00:00:00Z","timestamp":1404518400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2014,7,5]],"date-time":"2014-07-05T00:00:00Z","timestamp":1404518400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2015,9,1]],"date-time":"2015-09-01T00:00:00Z","timestamp":1441065600000},"content-version":"tdm","delay-in-days":423,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["ijgo.org","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["Intl J Gynecology &amp; Obste"],"published-print":{"date-parts":[[2014,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To investigate the timing of contraceptive use and estimate the discontinuation rates of temporary methods among women after abortion, or a live birth or stillbirth.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A sample of married women with detailed pregnancy and contraceptive histories was analyzed in a population\u2010based cross\u2010sectional study based on calendar data extracted from the 2011 Nepal Demographic and Health Survey. Kaplan\u2013Meier cumulative and discrete\u2010time hazard models were used to estimate the timing of contraceptive use and discontinuation rates among users of temporary methods.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The final analysis sample included 3190 women. Of 684 women who had had an abortion, 298 (43.6%) had not initiated any contraceptive use in the 12 months afterwards. Women initiated contraceptive use significantly earlier after abortion (hazard ratio [HR] 2.25; 95% CI, 1.96\u20132.59; <jats:italic>P<\/jats:italic> &lt; 0.001). The rate of discontinuation among contraceptive users was significantly higher in the postabortion group (HR 1.32; 95% CI, 1.05\u20131.65; <jats:italic>P<\/jats:italic> &lt; 0.05). Women who were educated, wealthier, had used contraceptives before the index pregnancy, had two sons and had autonomy initiated contraceptive use significantly earlier in the post\u2010abortion period than their counterparts.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Postabortion contraceptive use is low in Nepal. Postabortion family\u2010planning counseling and related services should be strengthened with systematic monitoring and follow\u2010up interventions.<\/jats:p><\/jats:sec>","DOI":"10.1016\/j.ijgo.2014.05.012","type":"journal-article","created":{"date-parts":[[2014,7,5]],"date-time":"2014-07-05T15:01:23Z","timestamp":1404572483000},"page":"132-137","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":17,"title":["Contraceptive behavior among women after abortion in Nepal"],"prefix":"10.1002","volume":"127","author":[{"given":"Sabu S.","family":"Padmadas","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mark","family":"Lyons\u2010Amos","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shyam","family":"Thapa","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2014,7,5]]},"reference":[{"key":"e_1_2_6_2_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1728-4465.2010.00228.x"},{"key":"e_1_2_6_3_2","unstructured":"World Health Organization Safe abortion: technical and policy guidance for health systems 2nd ed.http:\/\/apps.who.int\/iris\/bitstream\/10665\/70914\/1\/9789241548434_eng.pdf Published 2012. Accessed April 15 2014"},{"key":"e_1_2_6_4_2","unstructured":"Marie Stopes International Increasing family planning access and choice: Key lessons from Marie Stopes International's clinical outreach programmes.http:\/\/www.mariestopes.org\/sites\/default\/files\/12pp_Marie%20Stopes_Marketing_Outreach%20WEB.pdf Published 2012. Accessed April 18 2014"},{"key":"e_1_2_6_5_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0017155"},{"key":"e_1_2_6_6_2","unstructured":"FortA.L. KothariM.T. AbderrahimN.Postpartum care: Levels and determinants in developing countries. DHS Comparative Reports 15.http:\/\/www.measuredhs.com\/pubs\/pdf\/CR15\/CR15.pdf Published December 2006. Accessed April 18 2014"},{"key":"e_1_2_6_7_2","doi-asserted-by":"publisher","DOI":"10.2307\/2137943"},{"key":"e_1_2_6_8_2","unstructured":"World Health Organization Combined hormonal contraceptive use during the postpartum period.http:\/\/whqlibdoc.who.int\/hq\/2010\/WHO_RHR_10.15_eng.pdf Published January 26 2010. Accessed April 18 2014"},{"key":"e_1_2_6_9_2","unstructured":"World Health Organization Medical eligibility criteria for contraceptive use 4th ed.http:\/\/whqlibdoc.who.int\/publications\/2010\/9789241563888_eng.pdf Published 2010. Accessed April 18 2014"},{"key":"e_1_2_6_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0968-8080(04)24006-X"},{"key":"e_1_2_6_11_2","unstructured":"SinghS. WulfD. HussainR. BankoleA. SedghG.Abortion Worldwide: A Decade of Uneven Progress.http:\/\/www.guttmacher.org\/pubs\/Abortion\u2010Worldwide.pdf Published 2009. Accessed April 18 2014"},{"issue":"3","key":"e_1_2_6_12_2","first-page":"8","article-title":"Women having abortion in urban Nepal: 2005 and 2010 compared","volume":"39","author":"Thapa S.","year":"2012","journal-title":"Kathmandu Univ Med J (KUMJ)"},{"key":"e_1_2_6_13_2","volume-title":"Second Trimester Implementation Guide","author":"Ministry of Health and Population","year":"2011"},{"key":"e_1_2_6_14_2","volume-title":"Medical Abortion Scale up Strategy and Implementation Guide, 2009","author":"Ministry of Health and Population","year":"2009"},{"key":"e_1_2_6_15_2","doi-asserted-by":"publisher","DOI":"10.1017\/S0021932013000461"},{"key":"e_1_2_6_16_2","unstructured":"IPAS A better place for women: Abortion care in Nepal a decade after law reform.http:\/\/www.ipas.org\/~\/media\/Files\/Ipas%20Publications\/NepalAnnivRevE12.ashx Published 2012. 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Technical Brief #30.http:\/\/nfhp.jsi.com\/Res\/Docs\/TB30\u2010PPFP.pdf Published 2010. Accessed April 20 2013"},{"key":"e_1_2_6_23_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.contraception.2006.03.006"},{"key":"e_1_2_6_24_2","unstructured":"RutsteinS.O. JohnsonK.DHS Comparative Reports 6: The DHS Wealth Index.http:\/\/www.childinfo.org\/files\/DHS_Wealth_Index_(DHS_Comparative_Reports).pdf Published August 2004. Accessed April 18 2004"},{"key":"e_1_2_6_25_2","unstructured":"Ministry of Health and Population World Health Organization Center for Research on Environment Unsafe Abortion: Nepal Country Profile.http:\/\/www.crehpa.org.np\/download\/unsafe_abortion_nepal_country_profile_2006.pdf Published July 2006. Accessed April 18 2014"},{"key":"e_1_2_6_26_2","unstructured":"Poverty Reduction and Economic Management Sector Unit World Bank Large\u2010scale Migration and Remittance in Nepal: Issues Challenges and Opportunities. 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