title: Impact of immediate postabortal insertion of intrauterine contraception on repeat abortion.
abstract: BACKGROUND
  Of the 1.3 million abortions performed annually in the United States, approximately half are repeat procedures. Immediate postabortal intrauterine device (IUD) insertion is a safe, effective, practical and underutilized intervention that we hypothesize will significantly decrease repeat unintended pregnancy and abortion.
  
  
  METHODS
  All women receiving immediate postabortal IUD insertion in eight clinics of a Northern California Planned Parenthood agency during a 3-year period comprise the IUD cohort. We selected a cohort of controls receiving abortions but choosing other, non-IUD contraception on the day of the abortion visit in a 2:1 ratio matched by date of abortion. We obtained follow-up data on repeat abortions within the agency for both cohorts through 14 months after the 3-year period. We evaluated differences in repeat abortion between cohorts. All analyses were intent-to-treat.
  
  
  RESULTS
  Women who received an immediate postabortal IUD had a lower rate of repeat abortions than controls (p<.001). Women who received a postabortal IUD had 34.6 abortions per 1000 woman-years of follow-up compared to 91.3 for the control group. The hazard ratio for repeat abortion was 0.38 [95% confidence interval (CI), 0.27-0.53] for women receiving a postabortal IUD compared to controls. When adjusted for age, race/ethnicity, marital status, and family size, the hazard ratio was 0.37 (95% CI, 0.26-0.52).
  
  
  CONCLUSIONS
  Immediate postabortal intrauterine contraception has the potential to significantly reduce repeat abortion.
authors.affiliation: University of California, San Francisco, San Francisco, CA 94110, USA. goodmanmd1@aol.com
authors.forename: Suzan
authors.initials: S
authors.lastname: Goodman
authors.forename: Sarah K
authors.initials: SK
authors.lastname: Hendlish
authors.forename: Matthew F
authors.initials: MF
authors.lastname: Reeves
authors.forename: Anne
authors.initials: A
authors.lastname: Foster-Rosales
mesh_terms: D000032:Abortion, Therapeutic; D000328:Adult; D005193:Family Planning Services / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007434:Intrauterine Devices; D053208:Kaplan-Meier Estimate; D011247:Pregnancy; D016016:Proportional Hazards Models