Knowledge and use of contraception in women undergoing repeat termination of pregnancy
ESC Congress Library. van der Spuy Z. May 28, 2014; 50429; A-011 Disclosure(s): Research funded by JS Scratchley Trust
Prof. Zephne van der Spuy
Prof. Zephne van der Spuy
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Abstract
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Objectives: The aim of this study was to assess the indications for termination of pregnancy (TOP), the knowledge of contraception and barriers to contraceptive use among women undergoing repeat TOP within our clinical services.


Methods: A descriptive cross-sectional study was conducted within our TOP clinic involving women requesting repeat TOP. An investigator–administered questionnaire was used to interview them and was completed at their initial assessment.  The questionnaire included the participant’s demographic details, investigation of her current and previous TOPs, knowledge and use of contraception and previous post-TOP care. The perceived barriers to contraceptive use were also explored.


Results: A total of 102 women were interviewed and there were no refusals to participate.  The median age was 28yrs (range 18-44), 66 women were single and 36 married or cohabiting. The main reasons for requesting TOP were financial constraints (n=40), the last child being too young (n=15) and family complete (n=13). Knowledge of contraception included the male condom (n=100), injectable progestagens (n=99) and the combined oral contraceptive pill [COC] (n=92). The contraceptive methods they had ever used included injectable progestagens (n=83), male condoms (n=69) and the COC (n=36). Prior to the current pregnancy 48 participants used the male condom, 35 used no contraception and 21 used hormonal contraception.


The contraceptive method most commonly recommended by the healthcare professionals following the previous TOP was injectable progestagens.  Seventy two of the 76 women who received this advice initially utilized this contraceptive option.  Seven women elected not to accept contraception after the TOP.


Only 87 participants had previously accessed our family planning services, and the majority of them (n=73) found that these were helpful and approachable.  Fifty four of the respondents indicated that contraceptive services could be improved, 31 were satisfied with the service and 17 were uncertain about the service. Participants suggested that avoiding long waiting periods (n=16), health education for women (n=13) and changes in the attitudes of health care practitioners (n=11) would improve services.


Conclusions: The participants had reasonably good knowledge of contraception, but low contraceptive usage and adherence. Most unintended pregnancies in this study were related to either the non-use of contraception or the use of inefficient methods. The limited use of the highly effective long acting reversible contraception and emergency contraception was also highlighted. The opportunity for adequate contraceptive counselling after TOP was often missed.


 

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