Contraceptive use among immigrant and non-immigrant women seeking abortion care in Stockholm County
ESC Congress Library. Emtell Iwarsson K. May 10, 2018; 208116; ESC134
Karin Emtell Iwarsson
Karin Emtell Iwarsson
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Background Immigrant women encounter more challenges in reproductive healthcare than non-immigrants. A previous Swedish study showed being foreign-born was a risk factor for induced abortion and that immigrant women had less experience of contraceptive use as compared to non-immigrants. In order to ensure equitable care, it is important to investigate if this pattern still exists today. Objectives To compare the contraceptive use ever in life, at conception and planned use after an induced abortion, including type of methods, between immigrant and non-immigrant women seeking abortion care in Stockholm County. Design and Methods A cross-sectional study using an interview-based questionnaire was conducted at six abortion clinics. 637 women responded. Results In the study 425 were non-immigrants and 212 immigrants. A significant difference was observed within the immigrant group, therefore it was divided into foreign-born (148) and 2nd generation immigrants (64) according to the definition of Statistics Sweden. For all women, 96% reported they had used contraception ever in life. A statistical significant difference was seen where foreign-born women and 2nd generation immigrants had used contraceptives ever in life to a lower extent than non-immigrants. A significant difference was also seen by method where non-immigrants had used pills and withdrawal to a higher extent and foreign-born women had used copper intrauterine device (IUD). At time of conception, 32% had used contraceptives. No significant difference was seen between the different methods. Planned future use of contraceptives for all women was 93%. A slightly less planned use of contraceptives was seen among foreign-born women and 2nd generation immigrants compare to non-immigrants. Significant differences were seen in choice of contraceptive method where vaginal ring was more common among non-immigrant women, copper IUD among foreign-born women and implant among 2nd generation immigrants. For all women in the study, 53% planned to use long-acting reversible contraception (LARC) after the abortion. A significant difference was seen were non-immigrants planned to use LARC after the abortion to a lower extent than foreign-born women and 2nd generation immigrants. Conclusions: Significant differences were seen both in contraceptive use and methods between the different groups of women in the study at the different timeframes. Clinical implications To achieve an equitable care, efforts are needed to increase the contraceptive use among foreign-born and 2nd generation immigrants as well as increase the LARC use especially among non-immigrant women.
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