Do Women Undergoing Surgical Abortion Versus Medical Abortion Choose Different Methods of Contraception? [9A]

Abstract

INTRODUCTION: Elective termination of pregnancy (TOP) is an option for unwanted pregnancy. Effective contraception can prevent these unplanned pregnancies and terminations. The purpose of this study was to identify differences in post-abortion contraception among women who underwent surgical and medical abortion. Contraceptive choices were reviewed based on patient demographics. METHODS: A retrospective cohort study was conducted on 330 patients receiving abortions from January 1st through 15th, 2014 by review of electronic medical records from a private outpatient family planning clinic specializing in abortion services. Data analysis was conducted using Chi Square test. RESULTS: The 330 reviewed procedures were 53 medical TOPs, 219 1st trimester, and 58 2nd trimester surgical abortions. Of all patients 4.2% desired LARC, 78.2% desired other methods, 17.6% declined contraception. Patients with a medical TOP were most likely to have received a LARC method (22.6%) followed by those having first trimester procedures (10.5%) and second trimester procedures (8.6%), p=0.003. Significant loss of follow up was observed with medical TOPs (38.2%), 1st trimester surgical TOPs (68.0%) and 2nd trimester surgical TOPs (82.8%). Other factors influencing these choices are age, parity, prior abortion, insurance, and education. 18.2% of all patients returned pregnant within 18 months. CONCLUSION: Differences are seen in contraceptive choice and type of abortion. Age, parity, and a history of prior abortions may influence these choices. High follow-up failure and return pregnancy rates may suggest immediate contraception at time of procedure should be considered. Comparing these demographics with multivariate analysis could provide further understanding about these influencing factors.