Examining the influence of maternal characteristics on the use of contraception after abortion in the United States using the 2002 National Survey of Family Growth

Background: In the U.S., nearly half of all pregnancies are unintended and almost half of these end in abortion; 47 percent of all induced abortions are repeat procedures. Contraception, especially post-abortion contraception, may be the most effective way to prevent unintended pregnancies and repeat abortions. This is the first attempt to characterize post-abortion contraceptive use in the U.S. at a national level. Methods: 7,643 women aged 15-44 were interviewed from a national probability sample of U.S. households between March 2002 and March 2003. Pregnancies that ended in induced abortion from January 1999 to December 2002 were included. Contraceptive use was based on self-report of method and categorized by method effectiveness. Analysis was conducted using SAS and SUDAAN. Chi square, p <.05, was used to identify significant associations. Results: 1 month after abortion, 38% of women reported using no contraceptive method, 30% a moderately effective method, and 32% a highly effective method compared to 32%, 32%, and 36%, respectively, 3 months post-abortion. Poverty, lower education, informal marital status, and higher parity were significantly associated with lower contraceptive use 1 month after abortion. Only poverty was associated with contraceptive use 3 months after abortion. Conclusions: Women of lower poverty levels, lower educational achievement, and with more children were more likely to use no method or moderately effective methods compared to highly effective methods. These findings could be used to better inform issues of access to reproductive health services, appropriate public health interventions, and health service appropriations.