Comparison of contraceptive method chosen by women with and without a recent history of induced abortion

• Published in: Contraception (Stoneham) 2011-12, Vol.84 (6), p.571-577
• Main Authors: Madden, Tessa, Secura, Gina M, Allsworth, Jenifer E, Peipert, Jeffrey F
• Format: Article
• Language: English
• Subjects: Abortion; Abortion, Induced - psychology; Adolescent; Adult; Biological and medical sciences; Birth control; Cohort Studies; Contraception - methods; Contraception - psychology; Contraception Behavior; Contraception study; Contraceptive Agents, Female - administration & dosage; contraceptives; Drug Implants; Female; Females; Follow-Up Studies; Genital system. Reproduction; Gynecology. Andrology. Obstetrics; Historical account; Humans; Immediate postabortion contraception; Induced abortion. Therapeutic abortion; Intrauterine device; Intrauterine Devices; Medical sciences; Middle Aged; Missouri; Obstetrics and Gynecology; Pharmacology. Drug treatments; Postoperative Period; Pregnancy; Pregnancy, Unwanted - psychology; Prospective Studies; Surveys and Questionnaires; Young Adult
• ISSN: 0010-7824; 1879-0518
• DOI: 10.1016/j.contraception.2011.03.018

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 (RRadj ) 3.30, 95% confidence interval (CI) 2.67–4.85] and 50% more likely to choose the implant (RRadj 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.