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Contraception satisfaction and effectiveness post abortion:
A randomized controlled trial

Wendy Norman, University of British Columbia, 2010
See also publication in Trials.

Project abstract

In Canada, 35.5% of all induced abortions are repeat abortions. To prevent recurrent unintended pregnancy, our service offers a copper intrauterine device (IUD), placed at time of first trimester abortion. Our six-year retrospective review indicated higher than expected one- and five-year repeat abortion rates among women with an IUD placed at abortion. From our clinic data and discussions with Canadian physicians, it appears the only copper IUDs currently available in Canada may have expulsion rates higher than reported for devices available in other jurisdictions.

We hypothesize: 1. Recurrent abortion in women who choose to have an IUD placed at the time of abortion is directly related to expulsion of the device rather than voluntary removal or device failure. 2. Expulsion rates vary between copper IUDs currently available in Canada. 3. Women who choose to have IUDs inserted immediately post-abortion will have the highest rate of satisfaction and the lowest rate of repeat pregnancy when compared to other methods.

This prospective randomized controlled trial will examine satisfaction and effectiveness of post-abortion contraception by comparing the two types of copper IUDs currently available in Canada, and including a non-intervention group of other contraceptive options. Clinical experience suggests the Flexi-T 380+ has a higher expulsion rate than the Nova-T 200.

This will be the first prospective study comparing expulsion for these devices. The primary outcome measure is one-year expulsion rates of copper IUDs placed post abortion. Secondary outcomes are satisfaction with current method at 3, 6 and 12 months post-abortion, retention rates and repeat abortion rate over one year. One- and fiev-year pregnancy rate will be analyzed subsequent to this study, using access to universal health care databases.

Our results will provide the first information on the effectiveness of post-abortion contraceptive methods currently available in Canada.

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