Introduction Contraceptive provision at the time of abortion lowers rates of subsequent unplanned pregnancy but cost,method availability and other considerations impact decision-making.We examined factors associated w...Introduction Contraceptive provision at the time of abortion lowers rates of subsequent unplanned pregnancy but cost,method availability and other considerations impact decision-making.We examined factors associated with contraceptive preferences at the time of abortion in a US safety net hospital.Methods This is a retrospective cohort study.We abstracted medical records for patients seen in the gynaecology clinic between April 2019 and June 2021 who received a medication or procedural abortion for an undesired pregnancy.We collected demographic and clinical data from the electronic medical record.We generated descriptive statistics using Stata V.18 and used R to perform a latent class analysis to identify patterns of association with selected demographic variables and chosen contraceptive methods.Results 638 met inclusion criteria.Latent group 1,which was largely Hispanic,on Medicaid,and/or undergoing medication abortion,most often chose the subdermal implant or pills.Latent group 2,which was largely non-Hispanic and undergoing procedural abortion,most often chose a levonorgestrel intrauterine device(LNG IUD)or declined birth control.Nearly 80%initiated any contraceptive method,with over 20%choosing an LNG IUD and over 40%choosing any IUD or the subdermal implant.Contraceptive uptake was highest among Spanish-speaking individuals(115/131,87.8%).Non-initiation occurred most frequently among individuals who did not have insurance/self-paid(24/72,33.3%),spoke a language other than English or Spanish(8/27,29.6%),or had a procedural abortion<14 weeks(38/171,22.2%).Conclusions Contraceptive uptake was high among abortion-seeking individuals.Further research can clarify how other factors impact decision-making and uptake among vulnerable populations.展开更多
文摘Introduction Contraceptive provision at the time of abortion lowers rates of subsequent unplanned pregnancy but cost,method availability and other considerations impact decision-making.We examined factors associated with contraceptive preferences at the time of abortion in a US safety net hospital.Methods This is a retrospective cohort study.We abstracted medical records for patients seen in the gynaecology clinic between April 2019 and June 2021 who received a medication or procedural abortion for an undesired pregnancy.We collected demographic and clinical data from the electronic medical record.We generated descriptive statistics using Stata V.18 and used R to perform a latent class analysis to identify patterns of association with selected demographic variables and chosen contraceptive methods.Results 638 met inclusion criteria.Latent group 1,which was largely Hispanic,on Medicaid,and/or undergoing medication abortion,most often chose the subdermal implant or pills.Latent group 2,which was largely non-Hispanic and undergoing procedural abortion,most often chose a levonorgestrel intrauterine device(LNG IUD)or declined birth control.Nearly 80%initiated any contraceptive method,with over 20%choosing an LNG IUD and over 40%choosing any IUD or the subdermal implant.Contraceptive uptake was highest among Spanish-speaking individuals(115/131,87.8%).Non-initiation occurred most frequently among individuals who did not have insurance/self-paid(24/72,33.3%),spoke a language other than English or Spanish(8/27,29.6%),or had a procedural abortion<14 weeks(38/171,22.2%).Conclusions Contraceptive uptake was high among abortion-seeking individuals.Further research can clarify how other factors impact decision-making and uptake among vulnerable populations.
