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Post-abortion LARC—Repeat pregnancy rates

Aileen Langston, Columbia University Medical Center, 2010
See also executive summary.

Project abstract

Background: In the United States, 1.2 million induced abortions occur annually and half of all pregnancies are unintended. Publicly stated health objectives consistently include increasing the proportion of intended pregnancies, and public policy consistently separates abortion services from contraceptive services. Having long-acting reversible contraceptives (LARC) available for immediate use after an abortion can potentially reduce rates of unintended pregnancy.

Objectives:

  • To compare contraceptive methods chosen before and after LARC became available for immediate post-abortal use.
  • To quantify and compare the 12 month rates of repeat pregnancy in these two groups.
  • To utilize this data to support policy changes in contraceptive services.

Methods: Our design is a historical cohort study of contraceptive methods chosen and 12-month repeat pregnancy rates in a post-abortion population before and after LARC became available for immediate insertion. The study population is women who undergo a first trimester surgical abortion at a single academic practice in New York City. We aim to have 400 women in each group with 88% power to detect a change from 10% pregnancy rate in the exposed group to 18% pregnancy rate in the unexposed group.

We will collect the following data: 1) age, 2) gravida, 3) para, 4) prior abortion, 5) chosen contraceptive method, 6) method with patient at discharge, 7) results of most recent gonorrhea, chlamydia, and pap tests, 8) Medicaid category, and 9) any pregnancy outcomes in the 12 months following the procedure.

Our primary outcomes are 1) the contraceptive method selected and 2) the presence or absence of repeat pregnancy for 12 months following their procedure.


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