While few women treated for abortion complications have used family planning before, most want family planning (5, 49, 90, 92, 132, 179, 247). Also, for many women, emergency postabortion care may be one of their few contacts with the formal health system and an opportunity for them to receive family planning and other reproductive health services (87). Particularly for young women, postabortion care that links them to family planning and other reproductive health services can have a profound effect on their future health. Services, however, must always be offered as an option, rather than as a requirement or condition for receiving postabortion emergency care (188, 279, 282).

Missed opportunities. While the postabortion care setting is an important opportunity for offering family planning counseling and services, the opportunity is too often missed (33, 161, 170, 261). Few women in developing countries receive family planning counseling and services after their postabortion emergency care (87, 139, 188, 215, 246). A recent survey in Kenya, for example, found that 91% of providers reported that women treated after unsafe abortions do not routinely receive family planning information in their facilities, even though 86% thought that women should receive family planning information (215). Also, observations in two major Egyptian hospitals in 1994 found that fewer than 3% of women treated for postabortion complications were counseled about family planning (214). At one Turkish government hospital only 14% of women reported receiving family planning counseling and information, despite the fact that the doctors treating them were trained in family planning counseling and services (43).

Clinicians providing emergency postabortion care often do not see family planning services as part of postabortion care or as their responsibility (87, 200, 276). Often, physicians expect others to provide family planning counseling (246). Some providers mistakenly think that it is enough to tell a woman who has been treated for abortion complications, "You need to go to the family planning clinic when you leave here" (32). Some clinicians who do not routinely provide family planning services know little about family planning methods, are misinformed about contraceptive technology, or follow outdated guidelines about postabortion family planning use (140, 276).

For their part, few family planning programs specifically offer postabortion family planning counseling and services or see women who have had unsafe abortions as part of either their clientele for services or their audience for family planning communication (87, 148). Few family planning programs are linked to emergency care providers through a formal referral network. Also, family planning providers often are not familiar with the common complications of unsafe abortion or with treatment techniques and thus have limited understanding of which family planning methods are appropriate under what circumstances (87, 200).