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A comprehensive family planning after Pregnancy loss

Pregnancy loss affects subsequent needs for both emotional support and family planning in women. Women may experience and express negative feelings about their pregnancy loss regardless of original pregnancy intentions or initial reactions to the pregnancy. After a miscarriage, there may be varied future childbearing plans which may be in line with plans before miscarriage or altered, based on their experiences with pregnancy loss. These issues make pregnancies and family planning challenging. Pregnancy abortion clinic in Chennai manages these issues through patient-centred assessments of family planning needs and goals. The focus is to provide individualised support for each woman’s personal needs, goals and desire.

What is pregnancy loss?

One in 15 women are estimated to experience pregnancy loss. Pregnancy loss before the 20th week of pregnancy is referred to as a miscarriage or spontaneous abortion. Pregnancy loss from induced abortions often occur as solutions and compassionate care for women experiencing difficulties such as unintended pregnancy, nonviable pregnancy where continuing a pregnancy jeopardizes a woman’s life or when pregnancy scans reveal that an unborn baby won’t survive outside of the womb. A stillbirth that occurs after the 20th week is another type of pregnancy loss. In some countries women have access to abortion legally, while in other countries abortion is illegal. In both settings, some women obtain abortions from unskilled persons or try to abort themselves. These abortions are unsafe and often dangerous. They may cause infertility and severe and sometimes permanent health problems or even death. Women need to be aware of how dangerous an unsafe abortion can be, and encouraged to use contraception to avoid such a situation. Both women and health care providers need to know the signs of the complications of abortion and miscarriage and the importance of immediate medical care.

Need for comprehensive family planning needed after pregnancy loss

A woman would have to avoid having sex usually for 5 to 7 days from the time of pregnancy loss or until all bleeding stops. This can reduce the risk of infection after an abortion or miscarriage. Women who are treated for infection or abortion-related injury need to be sure the vagina or uterus has healed before having sex again. However, women who have had a recent pregnancy loss are frequently at higher risk of another pregnancy because after an abortion or miscarriage, fertility returns very quickly. A woman who wants to become pregnant again after an abortion or miscarriage is advised to wait for 6 months so as to regain strength for her next pregnancy. Therefore, a woman needs to start a comprehensive family planning method within one week to prevent another immediate pregnancy and to help prevent this pattern.

Though women have access to abortion legally, for varied reasons, some women obtain abortions from unskilled persons or try to abort themselves making it unsafe and often dangerous. Unsafe abortions can result in infertility and severe health problems that can become permanent or sometimes, even cause death. Awareness on how dangerous an unsafe abortion can be, signs of complications after abortion or miscarriage and the significance of immediate medical care are much needed among women and are encouraged to use contraception to avoid such a situation. For these reasons, safe abortion services in Chennai offer family planning as an essential part of post-abortion care. 

Challenges in meeting family planning after pregnancy loss

Most cases of pregnancy loss occur early in pregnancy, often before the initiation of prenatal care. women may not have a consistent medical provider caring for them during their pregnancy loss. Since there is high likelihood that a woman returns quickly to fertility after miscarriage, it is utmost important to address family planning at the time of pregnancy loss management. However, women experiencing miscarriage undergo potential emotional distress and may not feel comfortable addressing future childbearing goals and contraceptive needs immediately. Additionally, there is a general assumption that contraception after pregnancy loss is only desired by women with unplanned pregnancies. But the experience of pregnancy loss in women in terms of emotional and physical impact is very similar in planned as well as unplanned pregnancies. Hence, the objectives of comprehensive family planning should include exploring patients’ contraceptive needs after a pregnancy loss and discovering optimal strategies for addressing individual patient desires. Comprehensive family planning when approached sensitively, with the aim of helping patients achieve their reproductive goals, is acceptable to and appreciated by women receiving miscarriage care. Women should be allowed to identify their informational needs and optimal discussion timings that will create an opportunity for educating them about return to fertility after safe abortion in Chennai and the availability of comprehensive family planning resources. The main challenge is the vicious cycle of repeated unintended pregnancies and unwanted births or abortions that remains largely unattended. This contributes to increased morbidity and mortality among mothers and new born babies. 

Comprehensive family planning services

Services that form a part of comprehensive family planning programme include:

Counselling for post miscarriage/abortion contraception – The service provider considers both the woman’s clinical condition and personal situation to identify any potential barriers to the successful adoption of contraception and supports in a sensitive manner. 

Contraceptive methods – A wide range of contraceptive methods should be made available to women immediately after or when they receive health care for induced abortion or miscarriage. These may include oral contraceptive pills, use of condoms, IUDs or sterilization. The time of initiation of either of the methods varies with individual condition and choice.

Eligibility for post abortion family planning methods – It is important to ensure that there are no current severe complications, contraceptive options are made available and family planning method that the woman has opted for is suitable.

Women receiving care for pregnancy loss at a facility usually do not enquire or return for family planning services even if they do not desire to become pregnant again in the near future. The best opportune time to provide family planning services would be during the immediate post abortion period when the woman is still at the facility or in contact with safe abortion clinic in Chennai.