Wendy V Norman1, Melissa Brooks2, Rollin Brant3, Judith A Soon4, Ali Majdzadeh5, Janusz Kaczorowski6. 1. Contraception Access Research Team-Groupe de recherché sur l'accessibilité à la contraception, Women's Health Research Institute, British Columbia Women's Hospital and Health Centre, Vancouver BC; Department of Family Practice, University of British Columbia, Vancouver, BC. 2. Contraception Access Research Team-Groupe de recherché sur l'accessibilité à la contraception, Women's Health Research Institute, British Columbia Women's Hospital and Health Centre, Vancouver BC; Department of Obstetrics and Gynaecology, Dalhousie University, Halifax NS. 3. Contraception Access Research Team-Groupe de recherché sur l'accessibilité à la contraception, Women's Health Research Institute, British Columbia Women's Hospital and Health Centre, Vancouver BC; Department of Statistics, University of British Columbia, Vancouver, BC. 4. Contraception Access Research Team-Groupe de recherché sur l'accessibilité à la contraception, Women's Health Research Institute, British Columbia Women's Hospital and Health Centre, Vancouver BC; Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, BC. 5. Faculty of Science, University of British Columbia, Vancouver, BC. 6. Contraception Access Research Team-Groupe de recherché sur l'accessibilité à la contraception, Women's Health Research Institute, British Columbia Women's Hospital and Health Centre, Vancouver BC; Département de médecine de famille et de médecine d'urgence, Université de Montréal, Montreal, QC.
Abstract
OBJECTIVE: This report details enrolment findings related to a Canadian randomized controlled trial comparing immediate to delayed intrauterine contraception (IUC) placement after a second trimester abortion. We report acceptance of IUC, satisfaction with prior contraception, adherence to the CONSORT criteria, and challenges faced in the recruitment process. METHODS:Women seeking second trimester abortion and selecting either of two methods of IUC as their preferred contraception method were enrolled and randomized to insertion either immediately post-abortion or four weeks later. Enrolled participants completed a Contraception Satisfaction Questionnaire detailing prior contraceptive satisfaction. RESULTS: Among 1813 women assessed, 1500 (83%) met eligibility criteria andIUC was chosen for post-abortion contraception by over one half of them (792/1500, 53%). When both types of device were available cost-free, women selected the levonorgestrel-releasing intrauterine system more than 20 times more frequently than a copper IUD. Participants had an average age of 26.0 (standard deviation [SD] 6.8) years, and an average gestational age of 16.1 (SD 3.1) weeks. Almost one half (48.4%) had had a prior abortion and 46.9% had a prior delivery. Two thirds of participants were using a contraception method at the time of conception, but almost one third of these were using methods in the lowest tiers of effectiveness. There was a weak correlation between prior contraceptive compliance and education level. CONCLUSION: More than one half of eligible women seeking a second-trimester abortion chose IUC for post-abortion contraception. In Canada, health care for unintended pregnancies is universally subsidized but contraception is not. Offering comprehensive information on the range of contraceptive methods and providing cost-free IUC is an effective strategy to increase uptake of intrauterine contraception among Canadian women who wish to prevent further unintended pregnancy.
RCT Entities:
OBJECTIVE: This report details enrolment findings related to a Canadian randomized controlled trial comparing immediate to delayed intrauterine contraception (IUC) placement after a second trimester abortion. We report acceptance of IUC, satisfaction with prior contraception, adherence to the CONSORT criteria, and challenges faced in the recruitment process. METHODS:Women seeking second trimester abortion and selecting either of two methods of IUC as their preferred contraception method were enrolled and randomized to insertion either immediately post-abortion or four weeks later. Enrolled participants completed a Contraception Satisfaction Questionnaire detailing prior contraceptive satisfaction. RESULTS: Among 1813 women assessed, 1500 (83%) met eligibility criteria and IUC was chosen for post-abortion contraception by over one half of them (792/1500, 53%). When both types of device were available cost-free, women selected the levonorgestrel-releasing intrauterine system more than 20 times more frequently than a copper IUD. Participants had an average age of 26.0 (standard deviation [SD] 6.8) years, and an average gestational age of 16.1 (SD 3.1) weeks. Almost one half (48.4%) had had a prior abortion and 46.9% had a prior delivery. Two thirds of participants were using a contraception method at the time of conception, but almost one third of these were using methods in the lowest tiers of effectiveness. There was a weak correlation between prior contraceptive compliance and education level. CONCLUSION: More than one half of eligible women seeking a second-trimester abortion chose IUC for post-abortion contraception. In Canada, health care for unintended pregnancies is universally subsidized but contraception is not. Offering comprehensive information on the range of contraceptive methods and providing cost-free IUC is an effective strategy to increase uptake of intrauterine contraception among Canadian women who wish to prevent further unintended pregnancy.
Entities:
Keywords:
Canada; abortion; family planning; health services; induced; sexual health
Authors: Saied Samiedaluie; Sandra Peterson; Rollin Brant; Janusz Kaczorowski; Wendy V Norman Journal: BMC Health Serv Res Date: 2016-07-12 Impact factor: 2.655