title: Reasons for ineffective pre-pregnancy contraception use in patients seeking abortion services.
abstract: BACKGROUND
  We sought to better understand reasons for not obtaining desired contraception among women presenting for a pregnancy termination.
  
  
  METHODS
  A survey was completed by women prior to having an abortion procedure. Reasons for lack of access were categorized as institutional, individual and compliance issues. Descriptive statistics were calculated and variables compared using chi(2) tests.
  
  
  RESULTS
  Participants (n=298) ranged in age from 18 to 48 years. One third reported contraceptive use prior to pregnancy (37%). Approximately 72% of women reported some reason for not obtaining desired contraception, while 34% reported two or more. The distribution of reported individual, institutional, and compliance reasons were 44%, 28%, and 24%, respectively. Report of at least one reason was associated with a 35% increase in non-use (RR=1.35; 95% CI, 1.02-1.80) after adjusting for age, race, education, parity, and prior abortion.
  
  
  CONCLUSIONS
  Many reasons for not obtaining desired contraception exist and are associated with non-use of contraception. Removing these reasons may help reduce unintended pregnancies and rates of pregnancy termination.
authors.affiliation: Division of Clinical Research, Department of Obstetrics and Gynecology, Washington University in St. Louis School of Medicine, St. Louis, MO 63110, USA.
authors.forename: Juell B
authors.initials: JB
authors.lastname: Homco
authors.forename: Jeffrey F
authors.initials: JF
authors.lastname: Peipert
authors.forename: Gina M
authors.initials: GM
authors.lastname: Secura
authors.forename: Vanessa A
authors.initials: VA
authors.lastname: Lewis
authors.forename: Jenifer E
authors.initials: JE
authors.lastname: Allsworth
mesh_terms: D000023:Abortion Applicants / Q000706:statistics & numerical data*; D000293:Adolescent; D000328:Adult; D016009:Chi-Square Distribution; D003267:Contraception / Q000191:economics / Q000379:methods / Q000706:statistics & numerical data; D003268:Contraception Behavior / Q000706:statistics & numerical data*; D003625:Data Collection; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008875:Middle Aged; D010298:Parity; D011247:Pregnancy; D049168:Pregnancy, Unplanned; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires