Offer women IUDs, hormone shots after abortions: study

Women who get an abortion may be interested in long-acting forms of birth control, but they might not come back for another visit to get them. A new study suggests offering women those types of contraception right away may lower the chance they'll have another unintended pregnancy.

More than one million abortions took place in the U.S. in 2008, and about half of women getting an abortion had already had one before.

Researchers wanted to see if offering women long-acting reversible contraception immediately after an abortion would mean more of them would opt to use it. They also hoped this would reduce the number of second and third unintended pregnancies seen at their New York City facility.

Long-acting reversible contraception methods include intrauterine devices (IUDs), contraceptive implants inserted in the arm and hormone shots.

"Our patients already had access to effective contraceptives at no cost through a community clinic; however that required organizing an additional visit. That might sound easy, but for many it is hard to arrange childcare and additional time off from work that would permit another visit," Dr. Carolyn Westhoff told Reuters Health in an email.

Westhoff worked on the study at the Columbia University Mailman School of Public Health in New York.

"The result was that many women simply didn't make it back. Therefore we wanted to see what would happen if we could remove the obstacle of an extra visit," she said.

The study included women covered by Medicaid, the government-sponsored insurance program for the poor, who came into the facility for a first-term abortion.

In the first year of the study, women were given advice on various forms of birth control, but had to go to a different clinic if they were interested in long-acting contraception.

The next year women were given similar advice, but they were also offered the option of getting an IUD, implant or hormone shot immediately following the abortion, in the same facility.

Throughout the study period, women had equal access to other forms of birth control like condoms and the Pill, the researchers wrote in the journal Contraception.

Of the 407 women seen the first year, 135 were interested in referrals for IUDs, but only 45 actually had them inserted that year. Forty-nine women were interested in hormone shot referrals, but only one had the injection. Implants were not available.

Out of 405 women who were seen the next year and offered long-acting contraception immediately, 152 had IUDs inserted the same day. Another 33 had implants inserted and 17 women were given hormone shots.

The researchers followed women in both groups for one year after their initial abortion.

Women who didn't have immediate long-acting contraception access went on to have 111 pregnancies, including 70 abortions and 32 live births. Women who were offered long-acting reversible contraception right away had 62 pregnancies that resulted in 40 abortions and 15 births.