UK: Contraceptive methods and repeat abortions following termination of pregnancy

This randomised trial targeted women undergoing abortion in Edinburgh for improved contraceptive advice and provision. 

Lothian NHS Family Planning and Well Woman Services: 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 randomised trial. 

Between November 2001 and May 2002, women recruited at assessment for abortion were randomised at admission to receive specialist contraceptive advice and enhanced provision (316 women) or standard care (297 women). Randomisation 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.

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).

The authors concluded that 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.

Specialist contraceptive counselling and provision after termination of pregnancy improves uptake of long-acting methods but does not prevent repeat abortion: a randomized trial. Schunmann C, Glasier A. Human Reproduction. 2006 Sep;21(9):2296-303. Epub 2006 Jun 3.