title: Barriers associated with the failure to return for intrauterine device insertion following first-trimester abortion.
abstract: BACKGROUND
  The aim of the study was to identify barriers associated with the failure to return for delayed intrauterine device (IUD) insertion postabortion.
  
  
  METHODS
  This study had two components: (a) a retrospective cohort study of women who chose an IUD as their postabortion contraceptive method to compare characteristics of those who did and did not receive a device within 6 months of the procedure and (b) a prospective survey of women intending IUD use postabortion to assess actual IUD use at 6 weeks, barriers to access and attitudes on insertion timing.
  
  
  RESULTS
  Of the 500 abortion patient charts available for review during the study period, 53 women intended IUD use postabortion. At 6 months, only 32% intending an IUD received one, and there were no significant demographic differences between the groups. For the prospective portion, the response rate at 6 weeks was 54% (27/50), with only 26% (7/27) of responders reporting IUD insertion by this time. The principal reported barrier to IUD insertion was time needed for an additional visit (41%). Most women (67%) desired immediate insertion and believed that they would be more likely to have an IUD inserted if it is performed immediately postabortion (63%). Monthly income was the only statistically significant difference between those who responded to the 6-week follow-up (US$1409.50) and those who did not (US$937.50, p=.05).
  
  
  CONCLUSIONS
  A significant number of women that express a preference for IUD use after first-trimester abortion do not return to obtain a device. Most would prefer to have the option of immediate insertion.
authors.affiliation: Department of Obstetrics and Gynecology, Oregon Health and Science University, Portland, OR 97239, USA.
authors.forename: Ann M
authors.initials: AM
authors.lastname: Stanek
authors.forename: Paula H
authors.initials: PH
authors.lastname: Bednarek
authors.forename: Mark D
authors.initials: MD
authors.lastname: Nichols
authors.forename: Jeffrey T
authors.initials: JT
authors.lastname: Jensen
authors.forename: Alison B
authors.initials: AB
authors.lastname: Edelman
mesh_terms: D000028:Abortion, Induced; D000328:Adult; D005260:Female; D006801:Humans; D007434:Intrauterine Devices / Q000706:statistics & numerical data*; D010349:Patient Compliance / Q000706:statistics & numerical data*; D017060:Patient Satisfaction; D011247:Pregnancy; D011261:Pregnancy Trimester, First; D011446:Prospective Studies; D012189:Retrospective Studies; D013997:Time Factors; D055815:Young Adult