Prevalence and predictors of effective contraceptive use 6 months after an abortion
ESC Congress Library. Kumar U. May 28, 2014; 50443; A-025 Disclosure(s): This study was funded by a grant from the London Sexual Health Programme and supported by NIHR (National Institute for Health Research)
Dr. Usha Kumar
Dr. Usha Kumar
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Abstract
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Aims and Objectives: To investigate the prevalence and predictors of effective contraception 6 months after an abortion.
Method : Data from 148 women aged 16-45 years from the control arm of a randomised controlled trial designed to study the impact of contraceptive follow-up support to women undergoing abortion was analysed to assess the prevalence of effective contraceptive use at 6 months post-abortion and the factors associated with such use. 1006 women attending at three abortion clinics between October 2011- February 2013 were screened for eligibility. 921 were eligible, 569 consented to participate, who were allocated to an Intervention arm (n= 282) or Control arm (n= 287) through centre stratified randomisation. Participants completed a baseline questionnaire at recruitment and a telephone questionnaire at 6 months post-abortion. Baseline questionnaire included socio-demographics, previous obstetric history, contraceptive use immediately prior to abortion, intended method of contraception post-abortion, and type of abortion. The 6 month questionnaire included enquiry about contraceptive use, satisfaction with the method, contact with healthcare professionals for contraceptive advice since the abortion and pregnancy intentions in the next 12 months. Specialist contraceptive follow-up support at 2 to 4 weeks and 3 months post-abortion was provided to women in the intervention group only. In this presentation we report preliminary findings from the analysis of the 148 women in the control arm of the study who completed the 6 month follow-up. Effective contraception was defined as regular and consistent use of oral contraceptive pills/patches/vaginal ring/injectable contraception or use of intrauterine contraception or the contraceptive implant.
Results: Of the 287 women in the control arm, 6 withdrew from the study and 148 were available for follow-up at 6 months post-abortion. 88 (59%) were black, 43 (29%) white and 17 (12%) from other ethnic groups, and 76 (51%) of women had previous abortion. 55% (95% confidence interval CI [46.4-62.9]) were using effective contraception at 6 months. In multivariate logistic regression analyses, use of an effective contraceptive method before abortion and contact with a health care professional for contraceptive advice since the abortion were found to be significant predictors of effective contraceptive use at 6 months. There were no statistically signifcant differences in those who were using effective vs. non-effective contraception by ethnicity, socio-demographic factors, relationship status, previous abortion, parity, type of abortion or route of referral.
Conclusion: Prevalence of effective contraceptive use at 6 months post-abortion is low. Strategies aimed at influencing user intentions for effective contraception post- abortion and encouraging contact with health care professionals to help translate intentions to actual use could potentially improve contraceptive use in the long term.



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