Preventing unsafe abortion: Achievements and challenges of a global FIGO initiative.

FIGO established a Working Group on the Prevention of Unsafe Abortion in 2007 and a parallel program or "Initiative" with the same name. The initiative involved 46 FIGO member societies from seven regions: South-Southeast Asia, Eastern-Central Europe and Central Asia, North Africa and Eastern Mediterranean, Eastern-Central-Southern Africa, Western-Central Africa, Central America and Caribbean, and South America. Each society working in collaboration with the corresponding Ministry of Health and other agencies conducted a situational analysis and prepared a plan of action based on the findings. Such plans of action are continuously monitored by annual evaluation of the progress in the implementation at regional workshops. A substantial progress has been achieved in providing legal and safe abortion services, replacing curettage for manual vacuum aspiration or misoprostol and introducing and expanding postabortion contraception with emphasis on long-acting methods, such as IUDs and contraceptive implants.

Impact of structured counseling on the selection of hormonal contraceptive methods: results of a multi-centric, observational study in India.

OBJECTIVE: To determine the influence of "structured contraception counseling" on Indian women's selection of contraceptive methods. METHODS: Women (≥18 and ≤40 years) requesting contraception were enrolled at 36 sites. "Structured contraception counseling" was provided by a health care professional on the available contraceptive methods. Questionnaires on the women's pre- and post-counseling contraceptive choice, her perceptions, and the reasons behind her post-counseling decision were filled. RESULTS: Significant reductions were observed in the proportion of women who were indecisive (n = 260; 31.5 % pre-counseling vs. n = 30; 3.6 %, post-counseling [P < 0.001]) and women opting for non-hormonal method (24.6 % pre-counseling vs. 6.8 % post-counseling, [P < 0.001]). Of all the women counseled (n = 825), 89.6 % (739/825) of women chose a hormonal contraceptive method. There were significant difference (P < 0.001) in the women's choice of contraceptive in the pre- and post-counseling sessions, respectively (combined oral contraceptive: 30.8 vs. 40.7 %; vaginal ring: 1.8 vs. 14.1 %; progestogen only pills: 1.6 vs. 7.9 %; injectable-depot medroxyprogesterone acetate: 5.9 vs. 13.6 %; levonorgestrel-intrauterine system: 3.8 vs. 13.3 %). CONCLUSIONS: Structured contraception counseling using standardized protocol and aids resulted in a significant increase in the selection of modern contraceptive methods. Post-counseling majority of women opted for hormonal methods with an increase in selection of pills and newer alternatives.