title: Contraception at the time of abortion: high-risk time or high-risk women?
abstract: BACKGROUND
  Despite the widespread use of highly effective contraception in France, the incidence of abortion is high. A retrospective population-based cohort study was designed to analyse women's contraceptive history.
  
  
  METHODS
  We compared the contraceptive use of 163 women, whose last pregnancy ended in abortion, 6 months before, at the time of, 1 month and 6 months after the event with that of 1787 women who had never had an abortion.
  
  
  RESULTS
  A total of 46% of women who experienced an abortion used a highly effective form of contraception 6 months before the event (versus 76% among women who had never had an abortion, P < 0.001). This proportion dropped to 33% at the time of the abortion and increased to 71%, 1 month after. In addition, 50% of women who had an abortion had changed their contraceptive method in the 6 months before the event (compared with 16% in the 6 months before the interview in women who had not had an abortion, P < 0.001). Women with socially deprived backgrounds were less likely to use a highly effective contraception after an abortion.
  
  
  CONCLUSIONS
  Abortion is a good opportunity for intervention, but especially so for socially disadvantaged women. It is essential to draw the attention of prescribers and women to the higher risk of contraceptive failure at the start of use of a method.
authors.affiliation: INSERM INED U569, Hôpital de Bicêtre, Kremlin Bicêtre, France. bajos@vjf.inserm.fr
authors.forename: Nathalie
authors.initials: N
authors.lastname: Bajos
authors.forename: Agathe
authors.initials: A
authors.lastname: Lamarche-Vadel
authors.forename: Fabien
authors.initials: F
authors.lastname: Gilbert
authors.forename: Michèle
authors.initials: M
authors.lastname: Ferrand
authors.forename: Caroline
authors.initials: C
authors.lastname: Moreau
authors.forename: Jean
authors.initials: J
authors.lastname: Bouyer
authors.forename: Beatrice
authors.initials: B
authors.lastname: Ducot
authors.forename: Danielle
authors.initials: D
authors.lastname: Hassoun
authors.forename: Helene
authors.initials: H
authors.lastname: Goulard
authors.forename: Nadine
authors.initials: N
authors.lastname: Job-Spira
authors.forename: Monique
authors.initials: M
authors.lastname: Kaminski
authors.forename: Nathalie
authors.initials: N
authors.lastname: Lelong
authors.forename: Henri
authors.initials: H
authors.lastname: Leridon
authors.forename: Nicolas
authors.initials: N
authors.lastname: Razafindratsima
authors.forename: Clementine
authors.initials: C
authors.lastname: Rossier
authors.forename: Josiane
authors.initials: J
authors.lastname: Warszawski
mesh_terms: D000022:Abortion, Spontaneous / Q000453:epidemiology*; D000293:Adolescent; D000328:Adult; D015331:Cohort Studies; D003267:Contraception / Q000706:statistics & numerical data*; D005260:Female; D005602:France / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D008875:Middle Aged; D011247:Pregnancy; D012189:Retrospective Studies; D018570:Risk Assessment; D012959:Socioeconomic Factors