Post abortion LARC- repeat pregnancy rates
Awarded 2010
Small Research Grants
Aileen Langston, MD, MPH
University of British Columbia

Objective: To evaluate whether having IUDs, contraceptive implants, and injections immediately available to women undergoing abortion compared to requiring an additional visit for these methods leads to fewer repeat pregnancies and repeat abortions in the following 12 months. Methods: We conducted a historical cohort study with de-identified data from the health records of women obtaining a first trimester surgical abortion within a single practice in New York City. The women in Cohort 1 needed to have an additional visit to initiate the IUD, implant, or injection. The women in Cohort 2 were able to initiate these contraceptives on the same day as their abortion without an additional visit. We compared the proportions in each cohort that initiated different methods of contraception, had a repeat pregnancy, and/or had a repeat abortion in the 12 months following the index abortion. Results: Cohort 1 consisted of 407 women and Cohort 2 consisted of 405 women. The proportion initiating IUDs and implants was smaller in Cohort 1 compared to Cohort 2 (11% vs. 46%%, p<.001). The proportions with repeat pregnancy (27% vs. 16%, p <.001) and repeat abortion (17% vs. 10%, p=.003) over the following 12 months were greater for Cohort 1 than for Cohort 2. Conclusions: Making long-acting reversible contraceptive methods—IUDs and implants—available on the same day as an induced abortion instead of requiring an additional visit increases uptake of IUDs and implants and decreases repeat pregnancies and repeat abortions.