**Interventions for Failed Family Planning**

**Interventions for Failed Family Planning**

#### Li-Wei Chien and Heng-Kien Au Li-Wei Chien and Heng-Kien Au Additional information is available at the end of the chapter

Additional information is available at the end of the chapter

http://dx.doi.org/10.5772/intechopen.72239

**Abstract**

Despite the introduction of family planning services in most areas of the world, failures of contraceptive use often lead to unplanned pregnancies. These women often resort to unsafe methods to end their pregnancies, which contributes to the fourth leading cause of maternal mortality worldwide. Demographic variables that may affect the intention to discontinue the pregnancies would be demonstrated. Pros and cons of different types of induced abortions would be presented and discussed. Programs integrating counseling for women after failed family planning for future comprehensive reproductive health care will be shown. The gap between women's reproductive desire to avoid pregnancy and altitude of contraceptive use may contribute to the prevalence of unintended pregnancy. Age, race/ethnicity, marital status, and socioeconomic characteristics should be considered in counseling women after failed family planning. Expanding the program that offers integrated abortion training would prepare more physicians to provide comprehensive care for family planning.

DOI: 10.5772/intechopen.72239

**Keywords:** unintended pregnancy, induced abortion, use of contraception

#### **1. Introduction**

It was estimated that 7.9% (95% UI 4.7–13.2) of all maternal deaths were due to abortion by a global systemic analysis conducted by the World Health Organization (WHO) [1]. Although it is lower than that by the previous report, i.e., up to 13% [2], abortion-related deaths remain the fourth leading cause of maternal mortality after hemorrhage, hypertensive disorders, and sepsis (**Table 1**). Moreover, as deaths consequent to unsafe abortion have decreased in recent years, the focus is shifting toward adverse outcomes associated with abortion [3]. It is estimated that 7 million women were treated for complications from unsafe pregnancy termination in 2012 [4]. It is imperative that patients and families have access to the full spectrum of reproductive care options, including contraception method, pregnancy termination, and

Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. © 2018 The Author(s). Licensee IntechOpen. This chapter is distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

© 2016 The Author(s). Licensee InTech. This chapter is distributed under the terms of the Creative Commons


**Table 1.** Distribution of causes of deaths by millennium development goal regions. postabortion care. The provision of family planning policy is thus important in the women's

The term "family planning" has been used synonymously with contraceptive practice. In this review, we focus on interventions for failed contraceptive behavior or methods and address

Ineffective contraceptive use contributes to unintended pregnancy. In many Eastern European and South Asian countries, two-thirds of abortions are estimated due to contraceptive failure, mostly from traditional method use, and one-third are due to unmet need for contraception [2, 3]. In developed countries, it has been reported that most abortions occur as a result of

the data of the National Survey of Family Growth in the United States, the overall failure rate for reversible methods declined from 12% in 2002 to 10% in 2006–2010. Long-acting reversible contraceptives (the IUD and the implant) had the lowest failure rates (1%) and oral pills with the modest failure rate (6%), while condoms and withdrawal carried the highest probabilities

Unintended pregnancies unnecessarily expose women to the risks associated with pregnancy, unsafe abortion, and childbirth, thereby contributing to maternal mortality and morbidity. It has been estimated that 250,000 maternal deaths could have been prevented by contraception and an additional 30% of maternal deaths avoided by fulfillment of the unmet need for con

The World Health Organization defines unsafe abortion as "a procedure for terminating a pregnancy that is performed by an individual lacking the necessary skills, or in an environ

abortion complications as well as the demand for postabortion care also vary remarkably by geographic region. In many low- and middle-income countries (LMIC), abortion is illegal or highly restricted, leading some women to seek unsafe abortions. About 7 million women are

ies indicate that at least 8% of maternal mortality is due to unsafe abortion and the contribu

and mortality of unsafe abortion include lack of provider skill, poor technique, unsanitary conditions for performing the procedure, lack of appropriate equipment, use of toxic sub

stances, poor maternal health, increasing gestational age, and lack of access to postabortion

ment that does not conform to minimal medical standards, or both" [

tion of abortion may be as high as 18% of these deaths [

treated for complications from unsafe abortion procedures annually in LMICs [

7]. A reduction in the number of unintended pregnancies is the greatest

1,

5]. Based on

Interventions for Failed Family Planning http://dx.doi.org/10.5772/intechopen.72239 171






4]. Unsafe abortions and

9]. Factors that increase morbidity

8]. Two stud

contraceptive failure, and a small proportion are due to nonuse of contraception [

6].

reproductive care to reduce the morbidity and mortality.

unsafe abortion as a preventable outcome.

of failure (13% and 20%, respectively) [

traception in 2008 [

health benefit of contraception.

**2.2. Impact of unsafe abortion**

**2.1. Unintended pregnancy**

**2. Unintended pregnancy after the use of contraception**

postabortion care. The provision of family planning policy is thus important in the women's reproductive care to reduce the morbidity and mortality.
