Women Will Save the World by Caroline A. Shearer

Contraception enables women to effectively manage their fertility to prevent unintended pregnancies and potential complications arising from unsafe abortions in settings where access to safe abortion care is restricted. Out of 8 million unintended pregnancies that ended in abortions every year between 20 in the region, 77 percent were considered unsafe, leading to 185 maternal deaths per 100,000 abortions-the highest of any world region (Bankole et al. In sub‐Saharan Africa, most women of reproductive age (WRA 15–49 years old) live in countries that prohibit abortion or only allow it to save a woman's life. Globally, 45 percent of abortions are considered unsafe (Ganatra et al. Our findings suggest that ensuring that women have access to safe abortion as part of the formal health care system and receive comprehensive, high‐quality post‐abortion care services that include contraceptive counseling enables them to make informed decisions about their fertility that align with their reproductive goals.Ībortion is a safe health care intervention when conducted in accordance with recommended guidelines, yet unsafe abortion remains prevalent and a leading cause of maternal mortality, especially in settings where it is legally restricted (Say et al. Both post‐abortion contraceptive communication variables were associated with post‐abortion contraceptive use in both countries, whereas clinical source was only associated with post‐abortion contraceptive use in Nigeria. Obtaining care from a clinical abortion source was associated with increased adoption and decreased discontinuation. In Nigeria, wanting to talk to someone about contraception post‐abortion was associated with increased adoption and decreased discontinuation, whereas talking to someone about contraception post‐abortion was associated with increased adoption. We observed higher contraceptive use after abortion than before abortion.

Covariates included sociodemographic characteristics, abortion source, post‐abortion contraceptive communication (wanting to and actually talking to someone about contraception after abortion), and perceived contraceptive autonomy. Using data from population‐based surveys of women aged 15–49 in Nigeria and Côte d'Ivoire, we examined contraceptive dynamics immediately before and after an abortion and examined factors associated with these changes using multivariable logistic regressions. Post‐abortion contraception enables women to effectively manage their fertility to prevent unintended pregnancies.

Women Will Save the World by Caroline A. Shearer