Calling all high-risk patients: Can a simple telephone call increase contraception continuation after abortion?
Awarded 2010
Large Research Grants
Jody Steinauer, MD, MAS
University of California, San Francisco

Background: Women undergoing abortion are at high risk of poor contraceptive use and future unintended pregnancy. We sought to to investigate whether an informational phone call three weeks after having an abortion would improve contraceptive use six weeks after the procedure. Methods: This was a single-blinded, randomized controlled trial in women who chose a combined hormonal contraception method after abortion. Each participant completed a baseline questionnaire on the day of her abortion and a follow-up telephone survey six weeks later conducted by a research assistant blinded to whether she received the intervention. Three weeks after their abortions subjects randomized to the intervention received a telephone call which consisted of questions about contraceptive use, satisfaction, side effects and logistical challenges in using contraception, and in which the staff provided support and answers to the participants. The primary outcome was use of an effective method, including the combined oral contraceptive, the transdermal patch, the vaginal ring, the progestin injection, the contraceptive implant or an IUD, six weeks after abortion. Findings: Two-hundred seven women were randomized, and one person withdrew after randomization, leaving 102 women in Arm A and 104 women in Arm B. The study is still blinded until final analysis is complete. Follow-up rates were 67% in Arm A and 72% in Arm B. The intervention was completed in 71 subjects. Six weeks after abortion 80.9% and 73.3% were using an effective method of contraception in Arm A and B, respectively, (p=0.90). Analysis is ongoing. Conclusion: A telephone call three weeks after abortion does not affect effective contraceptive use six weeks after abortion in women who chose combined hormonal contraception as the post-abortion method.