Specialist contraceptive counselling and provision after termination of pregnancy improves uptake of long-acting methods but does not prevent repeat abortion: a randomized trial

Author： Schunmann C. Glasier Anna

Publisher： Oxford University Press

ISSN： 1460-2350

Source： Human Reproduction, Vol.21, Iss.9, 2006-09, pp. : 2296-2303

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Abstract

BACKGROUND: One in four abortions in the UK is undertaken for women who have had one before. Women undergoing abortion in Edinburgh were targeted for improved contraceptive advice and provision in this randomized trial. METHODS: Between November 2001 and May 2002, women recruited at assessment for abortion were randomized at admission to receive specialist contraceptive advice and enhanced provision (316 women) or standard care (297 women). Randomization was based on the week of admission. Contraceptive use 16 weeks after abortion was assessed by questionnaire and subsequent abortions by review of the hospital records 2 years later. RESULTS: Women receiving specialist advice and enhanced provision were more likely to leave the hospital with contraception (271 versus 115, P < 0.001),="" which="" was="" more="" likely="" to="" be="" a="" long-acting="" method="" (141="" versus="" 78,="">P < 0.001)="" than="" women="" receiving="" standard="" care.="" four="" months="" later,="" there="" was="" no="" significant="" difference="" in="" contraceptive="" prevalence="" or="" continuation,="" but="" women="" in="" the="" intervention="" group="" were="" more="" likely="" to="" be="" using="" contraceptive="" implants="" (32="" versus="" 6,="">P < 0.001).="" two="" years="" later,="" 14.6%="" of="" women="" in="" the="" intervention="" group="" (44/302)="" and="" 10%="" of="" controls="" (27/268)="" had="" undergone="" another="" abortion="" in="" the="" same="" hospital="">P = 0.267). CONCLUSIONS: Specialist contraceptive advice and enhanced provision had a short-lived effect on contraceptive uptake and increased the use of long-acting methods but did not appear to reduce repeat abortions.