Background Using a large national survey of women undergoing an abortion in France, we explore their contraceptive use surrounding an abortion. Study design The study comprised a representative sample of 7,541 women undergoing an abortion in 2007. We compared their use of contraception before and after the abortion and examined the factors associated with the prescription of a very effective method (IUD, hormonal methods) after the procedure. Results Sixty-six percent of women were using contraception in the month they conceived. A third of women reported the same use of contraception before and after the abortion, 54% were prescribed a more effective method while 14% changed to less effective or no method at all. After the abortion, 77% of women were prescribed a very effective contraceptive. Conclusions Abortion offers an opportunity to improve contraceptive uptake and a chance for providers to adjust their prescriptions according to the difficulties women experience in their use of contraceptives.

Background Using a large national sample of women undergoing an abortion in France, we explore the factors associated with medical or surgical abortion. We draw particular attention to the influence of women’s preferences in the decision making process. Study design The data are drawn from a nationally representative survey of 8,245 women undergoing an elective abortion in France in 2007. Analyses of factors associated with the type of abortion technique were performed among the 4,650 women who were identified as being eligible for the two techniques. Results Sixty-seven percent of all abortions were medical procedures among women eligible for both techniques. The type of abortion technique was not dependent on women’s age, parity, cohabitation status, socioeconomic circumstances nor on the type of facility providing the abortion (private or public). Conversely, women’s participation in the decision making process was strongly associated with the type of abortion method. Among the 50% of women who reported they had been given a choice, 84% underwent a medical procedure versus 52% of those who were not offered a choice. Among the 2,286 women who were not involved in the decision, 35% indicated they trusted their doctor to make the best choice for them, while 44% were told it was too late for a medical procedure, although they had consulted before 8 weeks of amenorrhea. Conclusion In this sample of French women who participated in a national survey on abortion, those who were involved in the decision making process as to whether to have a medical or surgical procedure showed a strong preference for the medical procedure.

Objectives The abortion rate varies greatly within the French overseas territories including the Caribbean island of Guadeloupe and La Réunion in the Indian Ocean. We compare women’s contraceptive paths surrounding an abortion in both territories. Methods The data for this study are part of a nationally representative survey of women undergoing abortion in France in 2007. The analysis included 1211women from Guadeloupe and 1531 from La Réunion. Results Results show differences in women’s use of contraception before the abortion by study location. Women in Guadeloupe were more likely not to have used contraception in the month they conceived (40% vs. 32%, p < 001). Among those using no contraception or less effective contraception before the abortion, 74% in Guadeloupe and 86% in La Réunion received a prescription for a very effective method such as a hormonal method or intrauterine device after the procedure. In both settings, women with no health insurance or a government health plan were 70% less likely to have received a prescription for a very effective method. Conclusions While this study shows a significant increase in the prescription of very effective methods, it also indicates the ineffectiveness of the health care system in closing the gap in the pre-abortion contraceptive disparities observed between Guadeloupe and La Réunion.

Résumé L’analyse des trajectoires contraceptives des femmes autour de l’IVG confirme les liens étroits entre contraception et avortement, en montrant que le recours à l’avortement traduit avant tout les difficultés de la pratique contraceptive au quotidien. Près de deux tiers des IVG (64 %) sont liées à des échecs de contraception, les grossesses survenant parmi les utilisatrices de pilule représentant le quart des IVG en France. Si l’IVG correspond à une opportunité d’aborder les questions contraceptives, près d’une femme sur cinq est sans prescription contraceptive après l’intervention, la moitié reçoit une prescription de pilule tandis que 30 % optent pour une méthode à longue durée d’action.