LARCs after unsafe abortion in Libreville (Gabon): Women accept quickly but the time interval for the insertion is longer than that of injectable contraceptives


Objectives: To determine the percentage of women who accepted a LARC after abortion, specify the interval time for the insertion of the LARC and compare such interval time with that of injectable and oral contraceptives. Patients and Methods: This is a prospective, descriptive and comparative study conducted in Libreville (Gabon), from February 1, 2013 to August 31, 2013. After receiving post-abortion care (PAC), all patients with stable general states were counseled about three types of contraceptive methods: combined oral contraceptive pills, LARCs (Jadelle? implants, Copper IUDs) and injectable Medroxyprogesterone Acetate (DMPA). Results: 231 women received PAC and among them 215 (93%) wanted to use one of the three proposed contraceptive methods. At the end of the study, only 193 women (89.7%) used contraception and 22 others (10.3%) abandoned their intentions. LARCs were used by 31 (16.0%) women. The average period for the insertion of LARCs was 15.4 ± 15.5 days with extremes of 1 to 53 days. This period for the insertion of LARCS was significantly longer than that of other methods (p < 0.001). LARCs were inserted more often after the 2nd day than immediately (same day) with a highly significant difference (p < 0.0001). Conclusion: LARCs could constitute an appropriate approach to reducing unintended pregnancies in Gabon. However, in order to increase their rates of use, it is necessary to improve women awareness.

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Mayi-Tsonga, S. , Ntamack, J. , Sima-Ole, B. , Obiang, P. , Minkobame, U. and Ngouafo, D. (2014) LARCs after unsafe abortion in Libreville (Gabon): Women accept quickly but the time interval for the insertion is longer than that of injectable contraceptives. Open Journal of Obstetrics and Gynecology, 4, 23-27. doi: 10.4236/ojog.2014.41005.

Conflicts of Interest

The authors declare no conflicts of interest.


[1] ACOG Practice No. 121 (2011) Long-acting reversible contraception: Implants and intrauterine devices. American College of Obstetricians and Gynecologists. Obstetrics & Gynecology, 118, 184-196.
[2] Peipert, J.F., Madden, T., Allsworth, J.E. and Secura, G.M. (2012) Preventing unintended pregnancies by providing no-cost contraception. Obstetrics & Gynecology, 120, 1291-1297.
[3] Eisenberg, D., McNicholas, C. and Peipert, J.F. (2013) Cost as a barrier to long-acting reversible contraceptive (LARC) use in adolescents. Journal of Adolescent Health, 52, S59-S63.
[4] Mayi-Tsonga, S., Litovchenko, O., Ndombi, I., De Souza, M.H. and Faundes, A. (2009) Delay in provision of adequate care to women who died from abortions related complications in the principal maternity of Libreville in Gabon. Reproductive Health Matters, 17, 65-70. 1016/S0968-8080(09)34465-1
[5] Mayi-Tsonga, S., Assoumou, P., Sima Olé, B., Bang, J., Meye, J.F. and Faundes, A. (2012) The contribution of research results to improvement abortion care in Libreville. Reproductive Health Matters, 20, 16-21.
[6] Biggs, M.A., Arons, A., Turner, R. and Brindis, C.D. (2013) Same-day LARC insertion attitudes and practices. Contraception, 88, 629-635.
[7] Morse, J., Freedman, L., Speidel, J.J., Thompson, K.M., Stratton, L. and Harper, C.C. (2012) Postabortion contraception: Qualitative interviews on counseling and provision of long-acting reversible contraceptive methods. Perspectives on Sexual and Reproductive Health, 44, 100-106.
[8] Rose, S.B., Lawton, B.A. and Brown, S.A. (2010) Uptake and adherence to long-acting reversible contraception post-abortion. Contraception, 82, 345-353. 2010.04.021
[9] Lewis, C., Darney, P. and Thiel de Bocanegra, H. (2013) Intrauterine contraception: Impact of provider training on participant knowledge and provision. Contraception, 88, 226-231.
[10] Tocce, K., Sheeder, J., Python, J. and Teal, S.B. (2012) Long acting reversible contraception in postpartum adolescents: Early initiation of etonogestrel implant is superior to IUDs in the outpatient setting. Journal of Pediatric and Adolescent Gynecology, 25, 59-63. jpag.2011.09.003
[11] Prata, N., Bell, S., Holston, M., Gerdts, C. and Melkamu, Y. (2011) Factors associated with choice of post-abortion contraception in Addis Ababa, Ethiopia. African Journal of Reproductive Health, 15, 51-57.
[12] Family Health International (2008) Africa: Fill the unmet need in family planning. The arguments in favor of permanent and long acting methods (PLAM) New York. Triangle Park.
[13] Demographic Survey of Health of Gabon (2012) Libreville. MSP/DGS. 2nd Edition.
[14] Mahomed, K., Healy, J. and Tandom, S. (1997) Family planning counselling a priority for post abortion care. Central African Journal of Medicine, 43, 205-207.

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