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Contraception following delivery or an induced abortion reduces the risk of an early unintended pregnancy and its associated adverse health consequences. Unmet need for contraception during the postpartum period and contraceptive counseling and services following abortion have been the focus of efforts for the last several decades. This article provides an introduction to the more focused contributions that follow in this special issue. We discuss the validity and measurement of the concept of unmet need for family planning during the postpartum period. We then present key findings on postpartum contraceptive protection, use dynamics, and method mix, followed by an assessment of interventions to improve postpartum family planning. The evidence on postabortion contraceptive uptake and continuation of use remains thin, although encouraging results are noted for implementation of comprehensive abortion care and for the impact of post-abortion contraceptive counseling and services. Drawing on these studies, we outline policy and program implications for improving postpartum and post-abortion contraceptive use. [ABSTRACT FROM AUTHOR]

A prospective study conducted between 1995 and 1998 assessed trends in contraceptive use in rural Rakai District, Uganda. Over a period of 30 months, women's use of modern contraceptives increased significantly from 11 percent to 20 percent. Male condom use increased from 10 percent to 17 percent. The prevalence of pregnancy among sexually active women 15-49 declined significantly from 15 percent to 13 percent. Women practicing family planning for pregnancy prevention were predominantly in the 20-39-year age group, married, better educated, and had higher parity than others, whereas women or men adopting condoms were predominantly young, unmarried, and better educated. Condom use was particularly high among individuals reporting multiple sexual partners or extramarital relationships. Contraceptive use was higher among women who desired fewer children, among those who wished to space or terminate childbearing, and among women with previous experience of unwanted births or abortions. Self-perception of HIV risk increased condom use, but HIV testing and counseling had only modest effects. Contraception for pregnancy prevention and for HIV/STD prophylaxis are complementary. [ABSTRACT FROM AUTHOR]

The article cites a study finding the determinants of birth-interval length in the Philippines, Malaysia and Indonesia. Logically, differences in birth-interval length can, be explained by differences in breastfeeding behavior, contraceptive use, frequency of intercourse, the incidence of abortion, and fecundity. First, birth order generally is not a significant covariate once other biological covariates are controlled. Second, the length of the previous interval is an important covariate. Short intervals are associated with short subsequent intervals, while long intervals are associated with long subsequent ones. The significance of any socioeconomic factors--ethnicity in Malaysia, male occupation in the Philippines, and urban residence and male occupation and education in Indonesia--in the Hazard models is puzzling, because the effects of the length of the previous interval as well as biological factors (such as age, contraception, and breastfeeding) have been controlled. These variables must be indicating differences that we have not been able to measure-differences in fecundity or coital frequency, in efficiency and length of use of contraception, or in the incidence of abortion.