Acceptance and Continuation of Contraceptive Methods Immediate Postabortion

Hou, Shuping; Zhu, Wenlei; Li, Shumin; Teng, Yincheng

doi:10.1159/000445292

Cited by 10 publications

(11 citation statements)

References 28 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…1 ). A total of 16 studies met inclusion criteria: 9 focused on medical abortion and 7 on surgical abortion ( Tables 2 and 3 ) [16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31] . We did not identify any studies of hormonal contraception use following spontaneous or septic abortion that met our inclusion criteria.…”

Section: Resultsmentioning

confidence: 99%

“…A second cohort study included 705 people who had a surgical abortion at 6 to 10 weeks gestation and initiated COC ( n = 230), Cu-IUD ( n = 240), or condoms ( n = 235) on the day of the surgical abortion [30] . The COC group exhibited shorter duration of bleeding (COC: 5 days [2-7], Cu-IUD: 7 days [2-10], condom: 5.5 days [3][4][5][6][7][8]; p = 0.041) on telephone follow-up at 1, 3, and 6 months.…”

Section: Hormonal Contraception Vs Nonhormonal or No Contraceptionmentioning

confidence: 99%

See 1 more Smart Citation

Systemic hormonal contraception initiation after abortion: A systematic review and meta-analysis

et al. 2021

View full text Add to dashboard Cite

Background: Immediate contraceptive initiation, including start of a method before abortion completion, is a convenient option for women seeking abortion care. Objectives: To evaluate the effect of systemic hormonal contraception initiation on medical abortion effectiveness and the safety of hormonal contraceptive methods following abortion. Data sources: PubMed, Popline, Cochrane Library, and Clinicaltrials.gov. Study eligibility criteria: Studies that assessed medical abortion effectiveness after systemic hormonal contraception initiation and the safety of hormonal contraception initiation after abortion. Participants: Pregnant persons undergoing or who had recently undergone an abortion. Interventions: Initiation of systemic hormonal contraception post abortion or on the day of the first pill of the medical abortion. Study appraisal and synthesis methods: We assessed study quality using the US Preventive Services Task Force evidence grading system. We created narrative summaries and calculated pooled relative risks when appropriate. Results: We identified 16 studies for inclusion, 7 randomized controlled trials, and 9 cohorts. Nine studies assessed medical abortion effectiveness with hormonal contraception initiation and generally found no decreased risk of abortion success or increased risk of additional treatment. One fair-quality study reported a small increase in ongoing pregnancy rate with immediate depot medroxyprogesterone (DMPA) compared with delayed DMPA initiation (3.6% vs 0.9%, risk difference 2.7%, 90% confidence interval 0.4-5.6). We identified no bleeding-related safety concerns following hormonal contraception initiation after medical or surgical abortion. Pooled results were too imprecise to draw firm conclusions. Limitations: Included studies were poor or fair quality and primarily in high-income or upper-middleincome settings. Conclusions: Abortion effectiveness did not differ between immediate vs delayed initiation of most systemic hormonal contraceptive methods after a first trimester medical abortion. However, immediate DMPA initiation did show increased ongoing pregnancy. Bleeding effects with hormonal contraception initiation postabortion appeared minimal. Implications: Initiating a hormonal contraceptive method after an abortion and as early as the same day as the first pill of the medical abortion is an option if contraception is desired. The slight increase in ongoing pregnancy with immediate DMPA initiation highlights the importance of information provision during contraceptive counseling.

show abstract

Section: Resultsmentioning

confidence: 99%

Section: Hormonal Contraception Vs Nonhormonal or No Contraceptionmentioning

confidence: 99%

Systemic hormonal contraception initiation after abortion: A systematic review and meta-analysis

et al. 2021

View full text Add to dashboard Cite

show abstract

“…Celen et al [6] found continuation rate of 76.3% at 12 months after post placental insertion of Copper T 380 IUD. Continuation rates for immediate post-abortion insertion of copper IUD after 6 months of use show the data at 77.9% [7] and 64.2% [8]. While a multicentre randomized clinical trial showed one-year continuation rate for Copper IUD was 76.3% [9] for interval insertion.…”

Section: Discussionmentioning

confidence: 99%

Continuation of Copper T in Immediate Postplacental, Immediate Postabortal and Interval Period of Insertion

Nath

Gaikwad

Nagpal

2021

J Obstet Gynecol India

View full text Add to dashboard Cite

AimCopper containing IUCDs are one of most effective mode of contraception for birth spacing. We conducted this prospective observational study to suggest a possible better period of insertion of IUCDs with cost-saving benefits. Methods All married women in the reproductive age group desirous of Copper-T 375 IUD insertion in either immediate postplacental (PP), immediate postabortal (PA) or interval (INT) period were recruited. The women were asked to return for scheduled follow-up visits at 6 weeks, 6 months and 12 months. They were advised to visit family planning clinic any time if they experienced pelvic pain, discharge per vaginum, unusual bleeding or missed periods. At each visit, women were interviewed for any side effects they have experienced and were asked to elaborate. Pelvic pain was assessed from visual analogue scale. Continuation rate was measured at the end of one year. Results Women in INT group (90.14%) had the highest continuation rate followed by PP (83.18%) and PA (80%) groups. Women in PP (AOR = 3.37, 95% CI 1.17-9.72) and PA (AOR = 4.53, 95% CI 1.33-14.04) groups had higher odds of discontinuation compared to INT group after adjusting for age, parity, working and education status. There was a significant difference between the groups when cumulative expulsion was considered (p = 0.045), but none when cumulative removal (p = 0.107) was taken into account. ConclusionThe continuation rate remained high in women who had insertion in the interval period compared to immediate postplacental and postabortal periods.

show abstract

“…10 In contrast the study by Shu-Ping Hou of 2015 concluded that the use of COCs in post abortion period had low continuation rates despite the pre-abortion contraceptive counselling. 11 The satisfaction level depicting the acceptability was 93 (77.5%) and 78 (65%) in ormeloxifene and COC respectively with statistically significant difference [p=78 (65%)]. Continuation rates decreased with time for both the groups.…”

Section: Continuation Ratesmentioning

confidence: 92%

A study to compare acceptability, safety and continuation rates of combined hormonal pill and centchroman as post abortion contraceptives

Miuli¹,

Dewan²,

Agarwal³

2020

Int J Reprod Contracept Obstet Gynecol

View full text Add to dashboard Cite

Background: Centchroman a non-steroidal selective estrogen receptor modifier (SERM). It is highly effective contraceptive which is devoid of side effects of COCs and there is prompt return of fertility upon discontinuation. Data in terms of its acceptability and continuation rates is limited when compared to combined oral contraceptive (COC). Therefore, the study was planned to study the acceptability, efficacy and continuation rates of centchroman and compare it with the combined oral contraceptives.Methods: The study was a prospective interventional comparative randomized study carried out in the department of obstetrics and gynecology VMMC and SJH, New Delhi, for a period of 18 months from November 2018 to April 2019.Results: A total of 945 women were screened and finally 240 women who met the criteria were recruited in 2 study groups of 120 women each. Majority were in the age group 18-28 years in either groups. Patients were followed up at 2nd week and then at 1st, 3rd, 6th and 12th months after initiation of the OCP with no loss to follow up. The pearl index in this study was 0.83 for ormeloxifene. The study showed statistically significant differences with higher level of satisfaction reported with 77.5% in the ormeloxifene compared to 65% of COCs. The continuation rates for ormeloxifene and COC users were in decreasing trend with increase in duration. No untoward events were reported with either formulation.Conclusions: Both the hormonal, combined hormonal contraceptive [combined oral contraceptive (COC), MALA-N] and the non-hormonal, centchroman (ormeloxifene) oral contraceptive pills are safe, effective, well tolerated and not associated with adverse outcomes when used immediately after abortion. Continuation rates of the pills in both the groups decrease in trend with time.

show abstract

Acceptance and Continuation of Contraceptive Methods Immediate Postabortion

Cited by 10 publications

References 28 publications

Systemic hormonal contraception initiation after abortion: A systematic review and meta-analysis

Systemic hormonal contraception initiation after abortion: A systematic review and meta-analysis

Continuation of Copper T in Immediate Postplacental, Immediate Postabortal and Interval Period of Insertion

A study to compare acceptability, safety and continuation rates of combined hormonal pill and centchroman as post abortion contraceptives

Contact Info

Product

Resources

About