Contraceptive discontinuation and repeat unintended pregnancy within 1 year after an abortion

Abstract

Background: We examined 12-month hormonal contraceptive continuation and pregnancy rates by abortion history.

Study design: Women who wanted to avoid pregnancy for at least 1 year were recruited at four San Francisco Bay area family planning clinics on regular service days and on abortion care days. Participants completed baseline and follow-up questionnaires. Multivariable Cox models assessed the factors associated with method discontinuation and pregnancy.

Results: Women who were enrolled into the study on the day of their abortion were 20% more likely to discontinue their contraceptive method than women who never had an abortion [adjusted hazard ratio (AHR)=1.21, 95% confidence interval (CI)=1.03-1.42]. Women who had a recent abortion or previous abortion were 60% more likely to have a pregnancy during follow-up than women who never had an abortion (AHR=1.63, 95% CI =1.21-2.20, and AHR=1.66, 95% CI=1.18-2.33, respectively).

Conclusion: The experience of having an unintended pregnancy and abortion does not lead to behavioral changes that protect against another unintended pregnancy.