Effect of contraception provided at termination of pregnancy and incidence of subsequent termination of pregnancy

Abstract

Objective To determine the incidence of subsequent termination of pregnancy (TOP) within a 2-year period in relation to the method of contraception provided to women following the index TOP.Design Case note review.Setting NHS hospital TOP service, Edinburgh, UK.Population Nine hundred and eighty-six women requesting a TOP in 2008.Methods Case notes were reviewed to determine the contraception provided at index TOP and whether women had subsequent TOP at the same hospital within 2 years.Main outcome measures Incidence of subsequent TOP within 2 years amongst women receiving different contraceptive methods.Results One hundred and twenty-one women (12.3%) of the 986 who attended the clinic requesting a TOP returned requesting another TOP in the subsequent 2 years. Both intrauterine contraception and the progestogen-only implant were associated with the lowest incidence of subsequent TOP. Using the combined oral contraceptive pill as the reference method, the odds ratios (ORs) and 95% confidence intervals (CIs) of a further TOP within 2 years with intrauterine contraception and the implant were OR = 0.05 (95% CI, 0.01-0.41; P < 0.001) and OR = 0.06 (95% CI, 0.01-0.23; P < 0.001), respectively. Women choosing the implant were significantly younger than those choosing the intrauterine method (P < 0.001).Conclusion Women undergoing a TOP who wish to avoid another unintended pregnancy should consider immediate initiation of either intrauterine contraception or the progestogen-only implant. Service providers should be trained and supported to provide these methods to women at the time of TOP.

Myths and misconceptions about intrauterine contraception among women seeking termination of pregnancy

“…The demographic characteristics of women participating in our survey were similar to that of previous studies of women attending for TOP in our region 10. In addition, our finding of 8% of women having previously used an IUD/IUS is in keeping with rates of uptake of intrauterine contraception in the UK 3.…”

Strengthening implant provision and acceptance in South Africa with the ‘Any woman, any place, any time’ approach: An essential step towards reducing unintended pregnancies

“…[68] LARC use among these women appears more effective than short-acting contraception in reducing repeat pregnancies and abortions. [69,70] In a multi-country trial, insertion of the implant immediately post abortion led to higher LARC use and reduced repeat pregnancies compared with insertion at a planned follow-up visit. [71] Also, in a study in Ethiopia, implant insertion immediately post abortion resulted in >80% of women leaving the facility with a contraceptive method compared with 58% before the services began.…”

Estudos experimentais no período gestacional: panorama da produção científica

“…In contrast, studies with a small sample, as evidenced in the study in which one of the CTs reported only having one subject enrolled, may lead to bias in the representativeness of the analysis. Randomization of eligible participants in intervention or control groups is another important point in this type of study, since it is a way of guaranteeing the same chance of allocation for both groups (23)(24) .…”