Abstract / Summary
To compare socioeconomic benefits of four effective contraceptive methods—intrauterine device (IUD), intrauterine system (IUS), compound norethisterone heptanoate injection (CIC), and combined oral contraceptive (COC)—in post-abortion care (PAC) services, evaluating 6-month continuation rates and benefit–cost ratios (BCRs) to inform fertility-friendly policies. We conducted a retrospective cohort study enrolling 696 women aged 15–40 years who received PAC services at Taiyuan Maternal and Child Health Hospital between January and June 2024, with complete data on the primary outcome (6-month continuation status) obtained for all enrolled participants via telephone and outpatient review. Descriptive statistics characterized baseline demographics. Partial correlation analysis examined associations between marital status and contraceptive choice, controlling for parity. BCRs were calculated as the ratio of no-contraception costs to method-specific costs, using direct medical expenses from the hospital charging system. Statistical analysis was performed using SPSS 29.0, with p < 0.05 considered significant. IUD and IUS achieved 82.5% 6-month continuation rates, while CIC and COC showed lower rates (81.0% and 60.8%, respectively). Annual costs ranged from ¥2,940.33 (approximately $429.66) (IUD) to ¥13,142.85 (approximately $1,920.50) (COC). BCR analysis demonstrated IUD as most cost-effective (0.51), followed by IUS (0.37), CIC (0.21), and COC (0.11). Controlling for parity, marital status correlated significantly with the motives for abortion ( r = 0.189, p < 0.001) and high-risk pregnancy status ( r = 0.189, p < 0.001), but not with the choice of post-operative contraceptive measure ( r = -0.049, p = 0.193). A significant negative correlation was observed with age ( r = -0.259, p < 0.001). Long-acting reversible contraceptives exhibit superior continuation and cost-effectiveness in PAC, with IUDs providing optimal value through government-funded provision. These findings support prioritizing LARC within patient-centered counseling frameworks that emphasize shared decision-making while respecting individual circumstances. Addressing barriers for unmarried women through targeted PAC education and multi-sectoral interventions is essential to reduce disparities, prevent repeat abortions, and protect reproductive health. Future multicenter studies with extended follow-up are needed to validate these findings and assess long-term socioeconomic impacts in diverse settings.