Investigation And Analysis Of Contraceptive Use And The Influencing Factors Of Accidental Pregnancy In Chinese Women After Delivery

[Objective]To investigate the contraceptive methods,the use of long-acting reversible contraception,the incidence of accidental pregnancy and artificial abortion among Chinese female after delivery,analyze the risk factors of accidental pregnancy and the factors affecting the choice made of using long-acting reversible contraception in above population.[Methods]Data consisting of 18045 parturients who delivered between July 2015 and June 2016 and then investigated by telephone questionnaire from April 2017 to January 2018 was from 60 hospitals in 15 provinces,regions and cities in the East,middle and west of China.300 women were randomly selected from each hospital one to two years after delivery.The shortest time to postpartum was 1 year,and the longest was 2.5 years.The contents of the questionnaire included their general situation,status of pregnancy,parturition,postpartum and breastfeeding,selection of contraceptive methods,postpartum second pregnancy and the outcome.The risk factors of accidental pregnancy and the factors affecting the choice made of using long-acting reversible contraception after delivery were analyzed.[Results]1.In this survey,5.30%(849)of the women did not take any contraceptive methods,of which the most chose contraceptive condom(72.80%,11779),14.50%(2344)chose traditional contraceptive methods such as safe period and in vitro ejaculation,3.70%(597)chose long-acting reversible contraception,1.20%(224)chose urgent contraceptive methods,0.90%(151)chose short-acting oral contraceptives and 0.30%(55)used sterilization for various reasons.2.The median time of menses recovery,sexual life recovery and contraception initiation was 6 months,3 months and 4 months,respectively.The time of using contraception was longer the time of sexual life recovery.3.The accidental pregnancy rate was the highest in 7-12 months after delivery(38.60%),followed by 13-18 months(30.20%).The difference of the accidental pregnancy rate in different periods of postnatal was statistically significant(P<0.001).72.83%of the accidental pregnancy performed artificial abortion.4.Unwanted pregnancy and contraceptive measures were distributed among all the respondents,and the rate of unwanted pregnancy was 8.81%(1590/18045).The rate of unwanted pregnancy was the highest(10.03%)in vitro sperm excretion and safe period contraception,and the rate of unwanted pregnancy was the lowest(2.85%)in long-acting contraceptive measures.Due to the failure of different contraceptive measures,the rate of unwanted pregnancy was statistically different(P<0.001).5.A total of 1 195 women underwent artificial abortion after delivery.The abortion rate was 6.62%,of which the highest was in the western(62.13%)and the lowest was in the east.The rate of induced abortion was statistically significant in different regions(P<0.001).6.The results of multivariate Logistic regression analysis showed that the factors influencing the choice of long-term reversible contraception methods after childbirth in Chinese women(P<0.001),education level(P=0.01),geographical area(P<0.001),number of months of breast-feeding(P=0.04),and number of months of exclusive breast-feeding(P<0.001)were the number of factors.7.Multiariable logistic regression analysis,the results show that the childbirth age(P<0.001),the national education level(P<0.001),(P<0.001),the way of delivery(P<0.001),contraceptive methods(P<0.001),progesterone(P=0.04),production time(P=0.02),breastfeeding months(P=0.04),postpartum menstruation recovery time(P=0.01),contraception startup time(P=0.02)are the independent risk factors influencing the postpartum an unwanted pregnancy.8.The results of multivariate logistic regression analysis showed that occupation(P<0.001),mode of delivery(P<0.001),number of deliveries(P=0.04),unwanted pregnancy(P<0.001)and previous history of induced abortion(P=0.02)were independent risk factors for postpartum induced abortion.[Conclusion]:1.The time when the respondents began to take contraceptive measures was significantly lagged behind the recovery time of sexual life.2.Chinese women are influenced by the traditional concept of postpartum contraceptive methods,such as condoms,in vitro sperm excretion,safety period and other traditional contraceptive methods,while the use rate of postpartum LARC is relatively low.3.The rate of unwanted pregnancy was 8.81%,of which the highest rate was among those using traditional conceptive measures and the lowest within those using long-acting reversible contraception.