264909 Intervening at a critical juncture: Women's motivation to use intrauterine contraception immediately following an abortion

Monday, October 29, 2012

M. Antonia Biggs, PhD , Bixby Center for Global Reproductive Health, University of California, San Francisco, San Francisco, CA
Susan Levy, BSN, JD , Boulder Valley Women's Health Center, Boulder, CO
Ellen Teig, MSPH , Boulder Valley Women's Health Center, Boulder, CO
Abigail Arons, MPH , Bixby Center for Global Reproductive Health, University of California, San Francisco, San Francisco, CA
Claire Brindis, DrPH , Philip R. Lee Institute for Health Policy Studies, University of California, San Francisco, San Francisco, CA
There is strong evidence that post-abortion insertion of intrauterine contraception (IUD) is safe, effective and more comfortable for the patient than delayed insertion. Yet, few abortion providers offer IUDs immediately following the abortion procedure. Recognizing the potential to decrease unintended pregnancies and repeat abortions through the provision of high efficacy methods, Boulder Valley Women's Health Center (BVWHC) implemented the Contraceptive Continuity Initiative (CCI) project, which covers the cost of long-acting methods, including IUDs, for uninsured and low-income patients. Our study aimed to learn about abortion clients' motivations and experiences using IUDs, when the barrier of cost is removed. During 2008-2010, 372 women at BVWHC had an IUD inserted during their abortion visit. Prior to their abortion visit, approximately half (49%) were not using any contraception and one-third (31%) were using a low-efficacy method such as condoms or spermicide. The most common reason for choosing an IUD was the desire for an effective (32%) and long-term method (33%). When compared to published rates, a substantially smaller proportion of women had their IUD removed (10%) or experienced an expulsion (3%) within the three-year study period. Two clients who received an IUD had a subsequent elective abortion after discontinuing their IUD. Data from post-abortion patients suggest that providing subsidies to low income and uninsured or underinsured women is associated with a substantial increase in adoption of high-efficacy methods.

Learning Areas:
Public health or related research

Learning Objectives:
1. Describe an intervention aimed at increasing the adoption of long-acting contraception in Colorado. 2. Assess the reasons abortion clients give for choosing IUDs 3. Discuss the factors associated with the discontinuation of IUDs among abortion clients.

Keywords: Abortion, Contraception

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am a senior researcher at the Bixby Center for Global Reproductive Health at the University of California, San Francisco. As a researcher for the Colorado and Iowa Initiatives to Reduce Unintended Pregnancy, I analyzed the data included in this abstract. I hold a B.A. in Psychology from the University of Wisconsin and an M.A. and Ph.D. in Psychology from Boston University.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

Back to: 3198.0: PRSH Posters: Contraception