Post-abortion family planning counselling practice among abortion service providers in China: a nationwide cross-sectional study

Objective: To assess the practice of post-abortion family planning (PAFP) counselling among Chinese abortion service providers, and identify the influencing factors. Methods: A cross-sectional questionnaire survey was conducted between July and September 2013 among abortion services providers in 30 provinces in China. Univariate and multivariable logistic regression analyses were used to identify the factors that influenced PAFP counselling. Results: 94% of the 579 service providers responded to the questionnaire in the survey. The median age was 39 years (range 20–72), and 95% were females. 92% providers showed a positive attitude and had promoted the PAFP counselling services; however, only 57% spent more than 10 min for it. The overall knowledge on PAFP was limited to the participants. After adjusting for potential confounding factors: providers from the middle region (compared with ‘east region’, OR_adj=3.33, 95% CI: 2.12–5.21) conducted more PAFP counseling; providers with more knowledge (OR_adj=2.08, 95% CI: 1.38–3.15) provided more counseling; and compared with ‘middle school and below’, providers with higher education gave more counseling [OR_adj(95% CI)] for ‘college’, ‘university’ and ‘master/doctor’ [1.99 (1.01,3.92), 2.32 (1.22,4.40) and 2.34 (1.06,5.17), respectively]. Conclusions: The majority of providers could provide PAFP counselling to women undergone an abortion, but some of them had insufficient time to make it available. Education, knowledge about fertility and reproductive health and residence region were the main factors influencing the practice. Training of health providers and integrating family planning as a part of abortion services are essential to provide adequate PAFP to abortion seekers, thereby reducing the risk of unintended pregnancy.