Women who use contraceptive implants and injections are more likely to have repeat abortions, a study published in the Journal of Family Planning and Reproductive Health Care (JFPRHC) has shown.
The large study conducted in the UK found that women who use implants or injections as their method of contraception following an abortion are more likely to have another termination.
— BMJ (@bmj_company) December 10, 2015
When a woman presents for an abortion in the UK, practitioners offer counselling on contraception. Currently the NHS guidelines advise healthcare providers to promote the use of long-acting reversible contraception (LARC) such as implants and the contraceptive injection above other methods such as pills or condoms.
Dr Anna Hatton of the Royal College of General Practitioners is a General Practitioner specialising in women’s reproductive health. She has, on average, around two women per day presenting to her looking for contraception following an abortion.
Speaking to Westminster World she explains: “Immediately following an abortion, these women are in a position where they do not want to become pregnant at this stage in their lives.”
“It’s very important that the healthcare professionals responsible for the advice given at the time of an abortion do their utmost to provide a method of contraception that will work for them, and that they will be able to continue to use.”
Why is LARC not working?
The authors of the study explain that while the LARC methods are effective when they are used continuously, “discontinuation rates are high.”
They found that many people find the side effects troubling and stop their treatment with LARC. Once they have stopped the treatment they are no longer protected against pregnancy, making “terminations more likely.”
Along with this, LARC only lasts for between one and three years, meaning that the patients must remember to go and have their treatment renewed.
Dr Sohinee Bhattacharya lead the study. She said of the patients: “They don’t get a recall like cervical screening. It’s up to them to make an appointment with the GP. Three years is a long time for you to try and get your Outlook to say when your implant is due for renewal.”
Summarised below are the two most common reasons for stopping treatment with LARC, as highlighted by the study.
How many people are affected by this?
Information for patients available from the NHS highlights that although abortions are a very safe procedure within the NHS, they can be distressing and ethnically complex. It is best to avoid them wherever possible.
One in three women in the UK will have more than one abortion in her lifetime.
How might this study start the process of improving things?
The authors of the study suggest that in the future, if a patient is given LARC following an abortion, that patient is followed up in the community to reduce discontinuation rates.
They also recommended that “downloadable mobile phone applications may play an important role in the future in reminding women that their contraceptive implant is due for renewal.”