The use of contraceptive methods among women seeking a legal abortion

Abstract

In a simple random sample study of 404 women 20 to 29 years of age, 201 applying for abortion and 203 continuing their pregnancies, all were interviewed personally and requested to complete a questionnaire. The aim of the study was to analyse the use and experience of contraceptives among the abortion applicants in this age group, and to compare their experience with that of women in a matched control group. The most important reasons given for desisting in the use of contraceptives were the experience of side effects, worry about the side effects, and the "human failure" factor involved even with methods of contraception such as pills, which generally are regarded as safe. This study demonstrates that women living alone without any permanent relationship, having a strained economy or having previously had an abortion, need particular and detailed contraceptive advice plus continued close follow-up. To improve the continuation rate, precise contraception counselling focusing on both positive and adverse effects to reduce worry seems essential.

PIP: A 1988 study in Sweden compared the experiences of contraceptives among 201 women, 20-29 years old, electing to undergo legal abortion with those of 203 age- and residence-matched pregnant controls. The researchers also wanted to study the contraceptive experiences of 20-29 year old women choosing abortion. All study subjects attended the family planning clinic of the University Hospital or maternity centers in Goteborg. Cases who had undergone at least 1 other previous legal abortion (A2) were more likely to report side effects from their chosen contraceptive than the controls (51% vs. 29%; p .01). Both these women and those undergoing their first legal abortion (A1) experienced contraceptive side effects more frequently than controls (p = or .01). Women in the abortion groups who had side effects were more likely to discontinue their current contraceptive method than those in the control group who had side effects (90.8% vs. 20.3%). The abortion groups were more likely to have side effects and fear side effects from the use of oral contraceptives (OCs) than the control group (33% for A1 and 45% for A2 vs. 22%; p .01). The most popular contraceptive used by all groups was OCs (79-84%). Among all 404 women, 77 (19%) became pregnant despite contraception use. Women in the abortion groups were more likely to be using a contraceptive when they conceived than controls (33.6% for A1 and 32.8% for A2 vs. 4.9%). Controls were more likely to be married or living together and had longer relationships than the abortion groups (95% vs. 33-44% and 5 vs. 1.5-2.5 years, respectively). Women in the abortion groups tended to have a poor economic situation (39-42% vs. 17% for controls). These findings show that family planning practitioners need to provide individualized and detailed contraceptive counseling, with continued follow-up, to women not in a permanent relationship, in a poor economic situation, or with a history of previous abortion.