Evaluation of the use of barrier contraceptives in women requesting termination of pregnancy at CHBAH
Date
2015-04-22
Authors
Maswime, Tumishang Mmamalatsi Salome
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Abstract
Introduction
South Africa has a high prevalence of unintended pregnancies and HIV. Sixty eight
thousand women die due to unsafe abortion annually worldwide, making it a leading
cause of maternal mortality. In SA the maternal mortality has decreased from TOP.
Maternal mortality from HIV is the leading cause of maternal mortality in South
Africa. Unintended pregnancies are mainly a consequence of inconsistent and
incorrect contraceptive use. The condom is the only contraceptive method which has
the dual ability of preventing HIV and unintended pregnancies. We postulate that the
failure of barrier contraception is a risk for both HIV and unwanted pregnancy. This
study describes the contraceptive methods used by women at a TOP clinic and
evaluates the use of barrier contraceptives amongst women requesting TOP, and the
prevalence of HIV.
Methods
CHBAH is tertiary hospital in Southern Gauteng. Women with medical or surgical comorbidities
that request a TOP are referred to the hospital. A prospective study using
a cross sectional study design was performed at the Chris Hani Baragwanath
Academic Hospital TOP clinic between February and October 2011. Data was
collected using interviews and medical files.
Results
One hundred and nineteen women were interviewed. Most women 56 (47.06%) did
not use any contraception at the time of conception. The most common reason for
TOP was financial constraints, followed by relationship conflict. Pregnancy despite
condom use was 34.45% (n=41). The percentage of women with condom failure,
who were HIV positive was 34.14% (n=14). True condom failure was experienced by
12 women (pregnancy due to breakage/slippage of the condom.
Conclusion
Unintended pregnancy is mainly associated with not using contraceptives. The male
condom was the most widely used contraceptive. The HIV prevalence in the group
with condom failure was higher than the general antenatal population. There is a
need for education regarding correct and consistent use of contraception.
Description
A RESEARCH REPORT SUBMITTED TO
THE UNIVERSITY OF THE
WITWATERSRAND IN FULFILLMENT
OF THE MASTER OF MEDICINE
DEGREE