Contraceptive practices in women with repeat termination of pregnancies.

The incidence of repeat termination of pregnancies (TOP) has been increasing in the past decade in-spite-of widespread availability of free and effective contraceptive methods. A retrospective analysis of case notes of women referred for TOP in the Family Planning clinic at Luton, between January and October 2005 was carried out. A total of 159 women were referred for TOP. Of these, 42 (26.4%) were repeat procedures. In this subgroup, 78.5% had used one or more contraceptive methods after the first termination. However, only 61.9% of them continued to use contraception at the time of presentation for a repeat TOP, the most common method being the male condom. Half of the total women seen for a repeat TOP were under 6-weeks' gestation and 14.2% had been treated for sexually transmitted infections in the past. The incidence of repeat TOPs is increasing in the UK. Many studies have shown that the periabortion contraceptive practices are generally poor. In our study, women undergoing repeat termination of pregnancies were either not using contraception or using a method with a high failure rate. We also found the highest number of repeat TOPs occurring in the 20 - 25 age group. Effective contraceptive counselling is vital to combat this worrying trend. Routine 2-week follow-up appointments after TOP and regular auditing of the periabortion contraceptive practices are needed.