Tessa Madden1, Gina M Secura, Jenifer E Allsworth, Jeffrey F Peipert. 1. Division of Clinical Research, Department of Obstetrics and Gynecology, Washington University in St. Louis School of Medicine, Saint Louis, MO 63110, USA. maddent@wustl.edu
Abstract
BACKGROUND: Women undergoing induced abortion may be more motivated to choose long-acting reversible contraception (LARC), including the intrauterine device (IUD) and implant, than women without a history of abortion. Our objective was to determine whether the contraceptive method chosen is influenced by a recent history of induced abortion and access to immediate postabortion contraception. STUDY DESIGN: This was a subanalysis of the Contraceptive CHOICE Project. We compared contraception chosen by women with a recent history of abortion to women without a recent history. Participants with a recent history of abortion were divided into immediate postabortion contraception and delayed-start contraception groups. RESULTS: Data were available for 5083 women: 3410 women without a recent abortion history, 937 women who received immediate postabortion contraception and 736 women who received delayed-start postabortion contraception. Women offered immediate postabortion contraception were more than three times as likely to choose an IUD [adjusted relative risk (RR(adj)) 3.30, 95% confidence interval (CI) 2.67-4.85] and 50% more likely to choose the implant (RR(adj) 1.51, 95%CI 1.12-2.03) compared to women without a recent abortion. There was no difference in contraceptive method selected among women offered delayed-start postabortion contraception compared to women without a recent abortion. CONCLUSION: Women offered immediate postabortion contraception are more likely to choose the IUD and implant than women without a recent abortion history. Increasing access to immediate postabortion LARC is essential to preventing repeat unintended pregnancies.
BACKGROUND:Women undergoing induced abortion may be more motivated to choose long-acting reversible contraception (LARC), including the intrauterine device (IUD) and implant, than women without a history of abortion. Our objective was to determine whether the contraceptive method chosen is influenced by a recent history of induced abortion and access to immediate postabortion contraception. STUDY DESIGN: This was a subanalysis of the Contraceptive CHOICE Project. We compared contraception chosen by women with a recent history of abortion to women without a recent history. Participants with a recent history of abortion were divided into immediate postabortion contraception and delayed-start contraception groups. RESULTS: Data were available for 5083 women: 3410 women without a recent abortion history, 937 women who received immediate postabortion contraception and 736 women who received delayed-start postabortion contraception. Women offered immediate postabortion contraception were more than three times as likely to choose an IUD [adjusted relative risk (RR(adj)) 3.30, 95% confidence interval (CI) 2.67-4.85] and 50% more likely to choose the implant (RR(adj) 1.51, 95%CI 1.12-2.03) compared to women without a recent abortion. There was no difference in contraceptive method selected among women offered delayed-start postabortion contraception compared to women without a recent abortion. CONCLUSION:Women offered immediate postabortion contraception are more likely to choose the IUD and implant than women without a recent abortion history. Increasing access to immediate postabortion LARC is essential to preventing repeat unintended pregnancies.
Authors: Rachel K Jones; Kathryn Kost; Susheela Singh; Stanley K Henshaw; Lawrence B Finer Journal: Clin Obstet Gynecol Date: 2009-06 Impact factor: 2.190
Authors: Ann M Stanek; Paula H Bednarek; Mark D Nichols; Jeffrey T Jensen; Alison B Edelman Journal: Contraception Date: 2008-10-22 Impact factor: 3.375
Authors: Tessa Madden; David L Eisenberg; Qiuhong Zhao; Christina Buckel; Gina M Secura; Jeffrey F Peipert Journal: Obstet Gynecol Date: 2012-11 Impact factor: 7.661
Authors: Amy G Bryant; Ilene S Speizer; Jennifer C Hodgkinson; Alison Swiatlo; Siân L Curtis; Krista Perreira Journal: South Med J Date: 2018-06 Impact factor: 0.954