Counseling intervention is successful to increase in post abortion IUCD acceptance

Introduction: The Government District Women Hospital (DWH) in Aligarh-India terminates over 2000 pregnancies each year, and accounts for 80% of the reported legal abortion. Although motivation to accept family planning post abortion is high, in 2009 the DWH reported low rates of post abortion family planning (PAFP) acceptance and no post abortion IUCD acceptance. Objective: To demonstrate the importance of post abortion counseling and service in increasing long acting family planning method use Method: Counseling was provided to all women, and their MTP slips were marked in green pen to indicate their choice of PAFP method. Providers were prepared to provide IUCD at the time of abortion as indicated in green pen. Routine review was made to ensure that the clients receive the service of their choice and systems were established to ensure supply and provider availability. Results: Rates of post abortion IUCD showed a dramatic increase from 0% of all MTP cases in 2009; to 6.7% in 2010 after 2 month of implementation and 26.1% in 2011. Overall, after introducing green pen with counselor, 49% clients accepted IUCD post abortion. In 2011, 65.9% clients received other methods. Conclusion: Pre MTP counseling along with family planning services at the time of abortion enabled women to accept a method especially the IUCD. The strategy, with simply made operational the Govt strategy, is highly effected to increase PAFP and easily replicable.This strategy makes a significant contribution to long acting contraceptive method use and holds the promise to reduce unplanned pregnancy and abortion.