The Influence of Trust in Health Care Systems on Postabortion Contraceptive Choice

Abstract

INTRODUCTION: After recent abortion women are at high risk for unintended pregnancy and repeat abortion. Use of highly effective contraception postabortion may mitigate this risk. Women cannot discontinue long-acting reversible contraception (LARC) without visiting a health care provider. This study investigates whether a womens trust in the health care system is associated with a willingness to consider LARC placement immediately postabortion. METHODS: A structured self-administered survey was provided to English-speaking women older than 18 years old presenting to a reproductive health center in the United States for first-trimester pregnancy termination. The survey collected information about demographics and reproductive history. We measured trust in the health care system with a validated scale. Statistical analysis was performed using chi tests Students t tests and logistic regression with SAS 9.2. RESULTS: One hundred sixty-two respondents completed surveys. Twenty-four percent indicated a plan to use LARC postabortion whereas 37% indicated they would accept LARC if available on the day of their abortion. The mean trust score was 59 (standard deviation 8 range 38-78) and did not differ significantly between women who indicated a willingness to use LARC immediately postabortion and others (P=.9). Demographic variables including education marital status income and prior pregnancy met criteria for inclusion in our multivariable model but none was ultimately predictive of LARC use postabortion. CONCLUSION: More than one third of participants reported that they would accept LARC immediately postabortion if available. In our study neither trust in the health care system nor demographic variables predicted willingness to accept LARC immediately postabortion.