Prescription of contraceptive methods in relation to repeated abortions: a longitudinal population study
Helena Kilander1, Siw Alehagen1, Linnea Widen1, Karin Westlund1, Johan Thor1, Jan Brynhildsen1 1Division of Nursing Science, Department of Medicine and Care, Faculty of Health Sciences, Linköping University, Linköping, Sweden, 2Division of Nursing Science, Department of Medicine and Care, Faculty of Health Sciences, Linköping University, Linköping, Sweden, 3Division of Nursing Science, Department of Medicine and Care, Faculty of Health Sciences, Linköping University, Linköping, Sweden, 4Department of Obstetrics and Gynaecology, Norrköping, Sweden, 5Jönköping Academy for improvement and welfare, Jönköping, Sweden, 6Obstetrics and Gynaecology, and Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden - firstname.lastname@example.org
Background: Use of long-acting reversible contraception (LARC) has been reported to reduce the risk of repeated abortion compared with use of other contraceptive methods. Swedish women have a long tradition of using intrauterine devices in comparatively large numbers. Despite good access to LARC, Sweden has a high proportion of repeated abortion. Objective: To study the prescription of contraceptive methods in relation to an abortion in a Swedish population and relate them to the likelihood of repeated abortions. We hypothesized that the prescription of LARC after abortion leads to reduced number of repeated abortions compared with other prescribed contraceptive methods. Method: A retrospective cohort study of women seeking abortion at three Swedish hospitals during 2009. The medical records of these women were scrutinized from the date of the index abortion during 2009 to the 31st of December 2012. The study population comprised 1032 women. Results: A total number of 266 (25%) women requested abortion(s) during the follow-up time. Oral contraceptives were prescribed to 43. 6% of the women and LARC were prescribed to 32.4% at the time of the index abortion. Prescription of LARC was associated with a reduced number of repeated abortions compared with prescription of oral contraceptives (OR 0.39 CI 0.26-0.56). Conclusions: The results of this study show that use of LARC is associated with reduced repeated abortion compared to other contraceptives. Implication: Abortion care needs an increased focus in motivating women and professionals to switch from oral contraceptives to LARC.