Contraception before and after termination of pregnancy: can we do it better?
OBJECTIVE
To compare contraceptive use pre- and post-therapeutic abortion in 1995, 1999 and 2002 in a New Zealand clinic.


METHODS
Retrospective, consecutive case review of women presenting for therapeutic abortion. Anonymous data included demographic details, contraception used at conception, and post-termination contraception.


RESULTS
Pre-conception contraceptive use is significantly declining, with post-termination condom choice increasing. This is predominantly due to increasing numbers of Asian women presenting for abortion. In 2002, 97% of Asian women used no contraception or only condoms pre-conception, and 62% chose condoms or abstinence post-termination. Oral contraceptives are used significantly less by Asian than European women both pre-termination (p = 0.0002) and post-termination (p = 0.00001). Other ethnic groups showed little change in contraceptive use over the study periods.


CONCLUSIONS
It is speculated that ethnic Chinese women lack adequate contraceptive education, demonstrate distrust of non-barrier methods, believe men should provide the prophylactic, and mistakenly believe contraception unnecessary for the first week following menstruation. Abortion may be used for family planning rather than as back up for contraceptive failure. Young Chinese arriving in New Zealand require immediate sexual health education including accurate contraceptive information. Liaison between primary healthcare sectors and policy makers of immigration and other services assisting overseas students is recommended to provide culturally appropriate education.
Goodyear-Smith
Felicity A
FA
Department of General Practice and Primary Health Care, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand. f.goodyear-smith@auckland.ac.nz
Arroll
Bruce
B
D000029:Abortion, Legal / Q000331:legislation & jurisprudence; D000032:Abortion, Therapeutic / Q000706:statistics & numerical data*; D000328:Adult; D044466:Asian People / Q000706:statistics & numerical data; D017280:Condoms / Q000706:statistics & numerical data; D003267:Contraception / Q000706:statistics & numerical data*; D003276:Contraceptives, Oral / Q000008:administration & dosage; D003281:Contraceptives, Postcoital / Q000008:administration & dosage; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D009520:New Zealand; D011247:Pregnancy; D011275:Pregnancy, Unwanted / Q000523:psychology / Q000706:statistics & numerical data; D012189:Retrospective Studies; D012736:Sex Education; D044465:White People / Q000706:statistics & numerical data
D003276:Contraceptives, Oral; D003281:Contraceptives, Postcoital