Objective: Our aim was to assess the changes in induced abortion in different migrant groups in China between 2007 and 2014 and the contraceptive methods used prior to induced abortion. Methods: The studies of two population-based cross sections were conducted in urban China, involving 9146 sexually active migrant women. Within the selected sociodemographic subgroups, the changes in the percentage of women who had induced abortions, the proportion of pregnancies ending in induced abortions, the causes of induced abortions, and the methods of contraception were identified. A chi-squared test was used to calculate the differences in induced abortion in the subgroups. Results: Between 2007 and 2014, in the study groups from the major cities of China, the percentage of sexually active migrant women who had induced abortions increased 10.1%, from 21.8% to 24.0%. The proportion of pregnancies ending in induced abortions increased 23.7%, from 21.5% to 26.6%. Both of the aforementioned statistics increased significantly within most of the selected sociodemographic subgroups, especially in the 18–19 and 45–49 age groups. Over 50% of pregnancies were aborted in the cohabiting group, although this figure declined by 12.3% over the course of the seven-year study period. Contraceptive failure was the primary cause of induced abortion, although its contribution to induced abortion declined from 51.3% to 42.4%. The proportion of women not using contraception prior to induced abortion increased from 30.9% to 41.2%. Conclusion: The prevalence of induced abortion is high and continues to increase among sexually active migrant women in China. An increasing trend is forecasted over the next few decades. Special attention should be paid to the younger cohort of migrant women, especially 18–19-year-olds, and unmarried cohabitants, who are increasingly seeking induced abortions.

Objective: This study was designed to assess the prevalence of reproductive tract infections (RTIs) among an internal-migrant population of reproductive age in China. We also analyzed the knowledge, attitude, and practices related to these infections. Methods: A cross-sectional study using the quota-sampling method was conducted in three cities from March 2016 to February 2017. A total of 3320 participants (40.7% men and 59.3% women) were enrolled in the study, of whom, 1124, 1015, and 1181 were from Yinchuan, Urumchi, and Shanghai, respectively. Data on the included subjects were collected using a self-administered questionnaire. Results: We found that 3.2% and 22.6% of all subjects lacked knowledge regarding the identification and prevention of RTIs, respectively. More than 80% of the participants approved of developing RTI surveillance and taking RTI-related courses. While 45.1% of the respondents changed their underwear every 2–3 days, 49.0% cleaned their genitals daily, and 34.9% reported taking a bath daily. Among contraceptive users, 47.4% and 29.7% used condoms and IUDs (intrauterine devices), respectively. Overall, 48.2% of the participants had laboratory-confirmed sexually transmitted infections, and 19.7% of the female participants had endogenous infections. After controlling the socio-demographic variables, participants who cleaned their genitals and took a bath less frequently, as well as used condoms or pills had a lower prevalence of sexually transmitted infections, while those who were unwilling to take RTI-related courses and changed their underwear less frequently were more likely to contract sexually transmitted infections. While women who were unwilling to take RTI-related courses had a lower prevalence of endogenous infections, those with more children had a higher prevalence. Conclusion: The status of RTIs among the internal-migrant population of reproductive-age is not optimistic and is related to multiple factors. We believe this study will contribute to improving the knowledge, attitude, and practices related to RTIs.

To explore the rate and influencing factors of unmet need for postpartum family planning (PPFP) in China. We conducted a retrospective cohort study at 60 hospitals in 15 provinces that were in eastern, central, and western regions of China. Participants were women who delivered a live birth at the study sites with an interval of 13 to 24 months between delivery and interviews. We selected participants using cluster randomization approach, and the first 300 postpartum women who gave a birth at each study hospital after the initial month that had been selected were interviewed. Information on the women’s background characteristics, pregnancy history, time when menstruation and sexual activity resumed after childbirth, the adoption of contraceptive method, breastfeeding, and any pregnancy or pregnancy outcome after delivery were collected. We performed life-table analysis to estimate the rate of unmet need for PPFP and a 2-level logistic regression model to explore factors that influence unmet need for PPFP within the first 24 months postpartum. A total, 19,939 postpartum women were screened in this study, of which, 17,466 (87.6%) were eligible for this analysis. The rates of unmet needs for any FP methods were 23.9% (95% confidence interval [CI] 23.3–24.6%), 11.8% (95%CI 11.3–12.3%); 10.6% (95%CI 10.1–11.1%) at 6, 12, and 24 months postpartum; these rates for modern FP methods were 35.5% (95%CI 34.7–36.2%), 25.6% (95%CI 24.9–26.2%), and 24.6% (95%CI 23.9–25.2%), respectively. Results of 2-level logistic regression analysis showed that less-educated young women, those who had only one child or delivered by vaginal delivery at secondary hospitals, were associated with increased risk of unmet need for PPFP. Approximately 31% of women who had unmet need for PPFP reported a pregnancy during the first 24 months postpartum, which was significantly higher than the level for their counterparts (10.0%). The level of unmet need for PPFP in China was high, resulting in a high pregnancy rate within 24 months after delivery. Women’s age, education level, prior pregnancy and abortion histories, and delivery method were significantly associated with the risk of unmet need for PPFP. National PPFP guidelines that integrate PPFP services into prenatal and postnatal care are urgently needed and should be implemented throughout the country as soon as possible. PPFP services should promote the use of modern contraceptive methods.

Background: The Woman’s Condom, a newly designed condom for women, has obtained market approval in China, but it remains relatively unfamiliar to the migrant population. The aim of this study is to evaluate the short-term acceptability of the Woman’s Condom and influencing factors among internal migrants. Methods: A longitudinal study was conducted among 1800 migrants in Beijing, Chongqing, and Shanghai in China between August 2013 and August 2014.Three-level model was implemented with the Statistical Analysis System software (v.9.4 SAS Institute) to analyze within-individual changes, between-individuals effects, and between-group effects. Results: Three-level model analysis revealed statistically higher short-term acceptability of the Woman’s Condom among subjects who lived in Shanghai (β = 6.50, t = 2.76, p < 0.01), unmarried and not in a cohabiting relationship (β = 3.05, t = 2.76, p < 0.01) than those who lived in Beijing, married and in a cohabiting relationship. Female (β = − 1.69, t = − 7.55, p < 0.01) and lower educational attainment (β = − 2.30, t = − 1.94, p = 0.05) were negatively related, while occupations of education, health, and civil staff (β = 1.50, t = 2.92, p < 0.01) were positively related to acceptability. It was predicted that migrants’ acceptability of the Woman’s Condom would significantly increase over time (β = 1.09, t = 5.54, p < 0.01). Conclusions: The findings indicate that the Woman’s Condom enjoyed relatively high short-term acceptability among migrants in China. In order to popularize the Women’s Condoms in migrants, more publicity, consultation and training in open and prosperous areas should be strengthened.

Objective This study evaluates the impact of a multilevel postpartum family planning (PPFP) intervention on contraceptive use within 12 months postpartum and the prevention of short inter-pregnancy intervals in China. Methods This multicentre, cluster-randomised trial involved 36 hospitals in China. Hospitals were randomly assigned to either the intervention or control group. Eligible participants were women who were at least at 36 weeks gestation who gave birth at these hospitals, followed for up to 1 year. Between 1 July and 31 December 2019, the first 180 eligible women at each hospital were invited to participate. Control participants received routine antenatal and postnatal care, while the intervention group received integrated PPFP services, enhanced counselling and free contraceptives. The primary outcome was postpartum contraceptive use. Contraceptive prevalence, including any methods, long-acting reversible contraceptives (LARCs), method switching and unmet need was assessed using life table analysis and multilevel Cox regression. Results A total of 6315 participants were recruited, with 3116 in the intervention group and 3199 in the control group. The intervention group had higher contraceptive prevalence (88.7% vs 70.2%) and LARC uptake (21.4% vs 15.1%) at 12 months postpartum. Cox regression analysis showed a 1.88-fold increase in contraceptive use, a 2.64-fold increase in LARC uptake and a 48% reduction in unmet need for modern contraceptives in the intervention group. No significant differences in method switching were observed. Conclusions The multilevel PPFP intervention effectively increased contraceptive use and LARC uptake while reducing unmet need for modern contraceptives among postpartum women. Trial registration Chictr.org.cn Identifier: ChiCTR1900023790 (URL: https://www.chictr.org.cn/).

Background Genital tract infections with ureaplasma urealyticum (UU) and chlamydia trachomatis (CT) are the most frequent sexually transmitted infections (STIs). The aim of this study is to understand the prevalence of UU and CT among general internal married migrants and to explore some possible influencing factors, so as to provide some evidences for STIs prevention in China. Methods A cross-sectional study was conducted in three cities of China from March 2016 to February 2017. A total of 3180 internal-married migrants were included. The structured questionnaire survey, gynecological or andrology examination and laboratory detection were conducted by the trained research fellow s. The prevalence of UU and CT was laboratory-confirmed in this study. Results The prevalence of laboratory-confirmed UU and CT were 45.41%, 5.75%, respectively. The co-infection rate was 4.09%. The rates of UU and CT of Shanghai participants (54.01%, 7.35%) were the highest, and the lowest were that of Yinchuan (37.74%, 4.52%). In Urumqi, the prevalence of UU and CT were 44.77%, 5.42%, respectively, but it has the highest co-infection rate. The multiple stepwise logistic regressions found that the prevalence of UU among three cities were different, and the male’s UU infection was lower than that of women (OR=0.71, 95%CI:0.61-0.83), and the 20-34 age group participants had lower UU and CT risk, compared with that of 45-49 age group. Moreover, the white-collar workers had lower risk of UU infection (OR=0.64, 95%CI: 0.49-0.83), compared with laborer, and using condom could reduce the UU infection (OR=0.74, 95%CI: 0.63-0.87). Compared with urban migrants, the rural participants had higher risk of CT infection (OR=1.68, 95%CI: 1.12-2.52), and sex behavior during menstruation could increase the prevalence of CT (OR=1.49, 95%CI: 1.05-2.11). Conclusion The prevalence of UU and CT were high and the co-infection was also serious among general internal married migrants. More health promotion measures about UU and CT should be taken to help general migrants of China, especially women and those with lower social-economic status (laborers from rural area), risky sexual behaviors such as having sex during menstruation should be warned of and condom-use should be promoted.