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The continued high prevalence of abortion among Russian women is a major concern of the health authorities at the national oblast (regional) and city levels. Although the abortion rate in Perm has declined by one-fourth since the mid-1990s (from 73.8 per 1000 women in 1996 to 55.6 in 2001) the abortion incidence in Perm has remained relatively constant over the past few years at approximately 18000 procedures per year. This study interviewed 1516 women having an elective abortion procedure. Nearly one-half (45.7%) were between 25 and 35 years old approximately three out of five (60.9%) were employed and four out of five (80%) were in a stable union. Of these women nearly three out of four (71.7%) had had a previous abortion and nearly one in five (18.6%) had had an abortion in the year preceding their index abortion. Nine out of ten women (89.9%) had used family planning in the past and two out of five women (43%) were using a family planning method at the time they got pregnant. Of the 1079 abortion clients followed up one year after the index abortion nearly one in five (17.2%) had an abortion complication and of these nearly one-half (46.2%) required hospitalization. The average cost of an abortion was 476 rubles ($16) whereas the average cost of one-year of contraceptive use ranged from a low of 123 rubles ($4) for the IUD to 741 rubles ($25) for contraceptive pills and 1008 rubles ($33) for condoms. Interventions in this study included: 1) training health care providers in postabortion care with an emphasis on strengthening interpersonal communication and family planning counseling skills; 2) developing provider job-aids (e.g. flipcharts) and client-education materials (such as brochures and posters) on postabortion family planning; and 3) providing free contraceptive supplies at selected sites. (excerpt)

Postabortion family planning operations research study in Perm, Russia