Abstracts of the RCOG World Congress 2015, 12-15 April, Brisbane, Queensland, Australia.

Abstract

Introduction Information about factors that lead to pregnanciesthat end in termination of pregnancy (TOP) has the potential tocontribute to programmes that improve health literacy and assistpeople to manage their fertility effectively.Methods A population-based cross-sectional survey wasconducted. The questionnaire and a letter of invitation toparticipate were mailed to a random sample of people aged 18–50extracted from the Australian Electoral Roll. Information wascollected about management of fertility and participants wereasked to provide details about their pregnancies and factors whichcontributed to the timing and intendedness of conception.Results There were 2235 respondents to the survey, of whom 1543were women; 1045 women provided details on a total of 2786pregnancies, of which 290 ended in TOP for reasons other than fetalabnormality. This paper presents some features of these 290pregnancies. For most the pregnancy was considered accidental and44% did not or ‘not really’ think there was a risk of pregnancy at thetime of the sexual intercourse that caused it, while 38% thoughtthere was such a risk. Twenty-five percent of terminated pregnanciesoccurred following non-use of contraception for reasons includingforgetting, unexpected sex, dislike of side effects and partner refusal.Thirty-one percent occurred following contraceptive problemsincluding method failure, late withdrawal, missed pills and brokencondoms. Eleven percent occurred when women believed they couldnot conceive due to it being a non-fertile time, health conditions orother reasons. For 18% of the TOPs, women reported factors fromtwo or all three of the above groupings. For 6% the only contributingfactors reported were alcohol or drug use or forced sex or both, whilecontributing factors were not reported for 9% of TOPs.Conclusion There was a high rate of misperception of pregnancyrisk at the time of conception in this sample. Education directedtowards more accurate understanding of fertility has the potentialto support more effective use of contraception and possibly choiceof methods with lower failure rates.