Continuation rates of self-administered subcutaneous DMPA and provider-administered intramuscular DMPA in patients seeking post-abortion contraception
Abortion, Contraception
Awarded 2022
In their hands: Exploring the potential of self-administered injectable contraception
Ashley Turner, MD, MSCI
Northwestern University

DMPA is available in both subcutaneous (DMPA-SC) and intramuscular (DMPA-IM) formulations. While DMPA-SC is only FDA-approved for provider-administration, the 2021 CDC Selected Practice Recommendations advised that DMPA-SC be made available for self-administration. Multiple prior studies have compared self-administered DMPA-SC to both provider-administered DMPA-SC and DMPA-IM and found that continuation rates for self-administered DMPA-SC are higher. Thus far, studies investigating self-administered DMPA-SC have focused on patients presenting for contraceptive services. Self-administered DMPA-SC has not been widely studied in patients seeking abortion services and has been more extensively studied in international settings than in the US. This is a prospective cohort study that will enroll patients who request DMPA for post-abortion contraception at a large, free-standing abortion clinic in Chicago, IL. Patients will choose either self-administered DMPA-SC or provider-administered DMPA-IM and will receive their first injection in the clinic after their abortion. Study participants will complete a baseline survey at the time of enrollment that will collect demographic and clinical characteristics. Patients will be provided with prescriptions for their second and third doses of DMPA and will receive follow up surveys at 3 and 6 months to assess continuation rates, reasons for discontinuing DMPA, pregnancy status, and patient satisfaction. This project will generate evidence that will support expanding access to DMPA-SC and providing patient education on self-injection, allowing for increased patient contraceptive autonomy.