Observation: Contraceptive Method Use Following an Abortion

Abstract

Researchers comparing 1st and repeat abortion patients directly have found that the latter were using methods that are only slightly or no more effective than those used by 1st-abortion patients at the time they became pregnant. It is here argued that such direct comparisons are not appropriate because repeat patients are not typical of all women who have ever had an abortion. Most women who use effective methods consistently after a 1st abortion will never appear in the repeat abortion statistics. Therefore in terms of contraceptive use repeat abortion patients overrepresent women who use no method or the least effective method. This point is illustrated using 1981-82 data collected by the Minnesota Department of Health on virtually all the states residents obtaining abortions in the state during a 2-year period. A total of 22070 women obtained 1st abortions and 8734 women repeat abortions. The data is collected by method used and shows the monthly contraceptive failure rate per woman the number of users per failure the estimated % distribution of women at risk of a 1st abortion the acutal distribution of those obtaining a 1st abortion and the estimated distribution of women at risk of a repeat abortion. Comparisons of these statistics show that of the women exposed to the risk of abortion those acutally obtaining one are disproportionately using no cotraceptives (70%) or the least effective method. The pill and sterilization were the methods used most commonly by the group exposed to the risk of a repeat abortion. By contrast at the time of the 1st abortion only 5% of women had been using the pill and less than 1% had depended on sterilization. Only 9% of women at risk of a repeat abortion used no method compared with 70% before the 1st abortion. Thus although women who have an abortion tend to be relatively poor contraceptive users after the abortion they use methods at least as effective as those used by women at risk of a 1st abortion. The data suggest a marked improvement in contraceptive practice subsequent to a 1st abortion. While a number of factors may contribute to this improvement it is probable that the abortion experience and the contraceptive services offered at the time of the abortion play an important role in improving contraceptive practice.