Factors predicting uptake of long-acting reversible methods of contraception among women presenting for abortion

Abstract

Objective: To examine the uptake of long-acting reversible contraceptive (LARC) methods after abortion among women seeking abortions through a major Australian abortion provider. Design and setting: Cross-sectional study of women’s post-abortion contraceptive choices, conducted at Marie Stopes International clinics across Australia between 1 September and 31 December 2012. Participants: 7267 of 9477 women (76.7%) presenting during the study period had data collection forms completed. Analysis was based on the 6348 women with completed demographic details. Main outcome measures: Uptake and immediate provision of LARC contraception after abortion. Results: Just over a quarter of women (1742; 27.4%) chose a LARC method for use after abortion. Of those choosing a LARC, immediate provision occurred in 71.1%. Compared with women aged 20-24 years, those aged 16-19 years were less likely to have immediate LARC insertion and those over 30 more likely. Women in the lowest socioeconomic quintile were the least likely to leave the service with their chosen LARC in place compared with those in higher quintiles. Immediate LARC provision occurred more often after surgical abortion compared with medical abortion (1034 [74.4%] v 204 [60.0%]; P < 0.001). Conclusion: Among women who opted for a LARC method after abortion, immediate provision was less likely to occur in women aged under 30 years, less likely as their level of disadvantage increased and more likely after surgical abortion compared with medical abortion. Public health policy needs to facilitate access to LARC methods after abortion so that more women are able to avoid a further unintended pregnancy.