Research
Women's sexual health and contraceptive needs after a severe obstetric complication ("near-miss"): a cohort study in Burkina Faso
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* Corresponding author: Rasmané Ganaba rganaba.muraz@fasonet.bf
1 Agence de Formation, de Recherche et d'Expertise en Santé pour l'Afrique (AFRICSanté), 01 BP 298 Bobo-Dioulasso, Burkina Faso
2 Department of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine (LSHTM), London, UK
3 West African Health Organization (WAHO), Bobo-Dioulasso, Burkina Faso
4 MRC Centre for Outbreak Analysis and Modelling, Department of Infectious Disease Epidemiology, Faculty of Medicine, Imperial College London, London, UK
Reproductive Health 2010, 7:22 doi:10.1186/1742-4755-7-22
Published: 27 August 2010Abstract
Background
Little is known about the reproductive health of women who survive obstetric complications in poor countries. Our aim was to determine how severe obstetric complications in Burkina Faso affect reproductive events in the first year postpartum.
Methods
Data were collected from a prospective cohort of women who either experienced life threatening (near-miss) pregnancy-related complications or an uncomplicated childbirth, followed from the end of pregnancy to one year postpartum or post-abortum. Documented outcomes include menses resumption, sexual activity resumption, dyspareunia, uptake of contraceptives, unmet needs for contraception and women's reproductive intentions.
Participants were recruited in seven hospitals between December 2004 and March 2005 in six towns in Burkina Faso.
Results
Reproductive events were associated with pregnancy outcome. The frequency of contraceptive use was low in all groups and the method used varied according to the presence or not of a live baby. The proportion with unmet need for contraception was high and varied according to the time since end of pregnancy. Desire for another pregnancy was highest among near-miss women with perinatal death or natural abortion. Women in the near-miss group with induced abortion, perinatal death and natural abortion had significantly higher odds of subsequent pregnancy. Unintended pregnancies were observed mainly in women in the near-miss group with live birth and the uncomplicated delivery group.
Conclusions
Considering the potential deleterious impact (on health and socio-economic life) of new pregnancies in near-miss women, it is important to ensure family planning coverage includes those who survive a severe complication.