避孕方法知情选择对人工流产发生的影响

目的:从个体角度解析知情选择避孕方法对人工流产发生的影响,并进一步探究两者间的相互关系。方法:采取病例对照研究方法(case-control),根据已婚育龄妇女管理信息系统登记名单,从浙江省德清县、山东省即墨市、安徽省居巢区、宁夏回族自治区中卫市四县(市、区)中,每县(市、区)随机抽取在2002￣2004年间有过人工流产经历的已婚妇女200名,以及截止2004年底从未有过人工流产经历的已婚妇女200名进行1∶1配对。结果:IUD使用者对IUD禁忌证、副作用知情,以及避孕套使用者对正确使用知识知情,可降低人工流产的发生;此外,促进群众能够主动地选择避孕节育方法,而不是由计划生育干部代替选择,则人工流产的发生会降低。从提供个性化咨询服务、规范化筛查服务以及常规化随访服务等方面提高服务能力和质量,促进知情和自主选择避孕方法,可以降低人工流产的发生。结论:对使用IUD和避孕套者,知情可降低人工流产的发生;自主选择对减少避孕失败的发生有重要的影响;技术服务贯穿整个知情选择的全过程,服务到位是降低人工流产的重要手段。

Influence of informed choice on induced abortion

Objective： To uncover the influence of informed choice on induced abortion and relationship between informed choice and induced abortions. A case-control method for epidemiological study was performed. Methods： Of the four selected counties, De qing （Zhejiang）, Jimo （Shandong）, Juchao （Anhui） and Zhongwei （Ningxia）, 200 women who had a history of induced abortion were selected for each county according to the name list registered with the local information management system for married women of childbearing age. And each of them was paired with another woman who had never had a history of induced abortion by the end of 2004. Results： Clients using the IUD were informed on contraindication and side effects for IUD, and clients using the condom were informed on how to correctly use the condom, these could reduce the possibility of induced abortion. Furthermore, clients could choose contraceptive methods more independently rather than decision-making for users by some cadres, induced abortions could also be declined. And reduce of induced abortion could be happened by improving the capacity and quality of service like providing the services on counseling, screening and follow-up. Conclusion： For IUD and condom user, induced abortion can be reduced if client was informed of contraceptives that she chose. A very important impact on induced abortion whether contraceptive method was chosen independently. Technical services will be put into the whole process of informed choice; good quality of services is very important method to reduce the induced abortion.