title: Peri-abortion contraceptive use in the French islands of Guadeloupe and La Réunion: variation in the management of post-abortion care.
abstract: OBJECTIVE
  The abortion rate varies greatly within the French overseas territories including the Caribbean island of Guadeloupe and La Réunion in the Indian Ocean. We compare women's contraceptive paths surrounding an abortion in both territories.
  
  
  METHODS
  The data for this study are part of a nationally representative survey of women undergoing abortion in France in 2007. The analysis included 1,211 women from Guadeloupe and 1531 from La Réunion.
  
  
  RESULTS
  Results show differences in women's use of contraception before the abortion by study location. Women in Guadeloupe were more likely not to have used contraception in the month they conceived (40% vs. 32%, p < 0.0001). Among those using no contraception or less effective contraception before the abortion, 74% in Guadeloupe and 86% in La Réunion received a prescription for a very effective method such as a hormonal method or intrauterine device after the procedure. In both settings, women with no health insurance or a government health plan were 70% less likely to have received a prescription for a very effective method.
  
  
  CONCLUSIONS
  While this study shows a significant increase in the prescription of very effective methods, it also indicates the ineffectiveness of the health care system in closing the gap in the pre-abortion contraceptive disparities observed between Guadeloupe and La Réunion.
authors.affiliation: Inserm, CESP Centre for Research in Epidemiology and Population Health, U1018, France. caroline.moreau@inserm.fr
authors.forename: Caroline
authors.initials: C
authors.lastname: Moreau
authors.forename: James
authors.initials: J
authors.lastname: Trussell
authors.forename: Julie
authors.initials: J
authors.lastname: Desfreres
authors.forename: Nathalie
authors.initials: N
authors.lastname: Bajos
mesh_terms: D000028:Abortion, Induced / Q000379:methods; D000293:Adolescent; D000328:Adult; D003267:Contraception / Q000706:statistics & numerical data*; D003268:Contraception Behavior / Q000706:statistics & numerical data*; D005260:Female; D019430:Guadeloupe; D006801:Humans; D007195:Indian Ocean Islands; D011795:Surveys and Questionnaires; D055815:Young Adult
references.citation: Contraception. 2003 Feb;67(2):107-13
references.pmid: 12586321
references.citation: Int Fam Plan Perspect. 2003 Mar;29(1):6-13
references.pmid: 12709307
references.citation: Hum Reprod. 2003 May;18(5):994-9
references.pmid: 12721175
references.citation: Hum Reprod. 2006 Sep;21(9):2296-303
references.pmid: 16751644
references.citation: Reprod Health Matters. 2005 Nov;13(26):44-53
references.pmid: 16291485
references.citation: Plan Parent Chall. 1993;(1):27-9
references.pmid: 12345322
references.citation: Perspect Sex Reprod Health. 2002 Nov-Dec;34(6):294-303
references.pmid: 12558092
references.citation: Hum Reprod. 2006 Nov;21(11):2862-7
references.pmid: 16845119