title: Unintended pregnancy and therapeutic abortion in the postpartum period. Is an opportunity to intervene being missed?
abstract: OBJECTIVE
  To explore the reasons why women have an abortion soon after delivering an infant and what could reduce unintended pregnancy and abortion in this group of women.
  
  
  METHODS
  Data were collected from anonymous self-complete questionnaires from women who presented to a first trimester Termination of Pregnancy service and who had delivered a live-born infant within the preceding 6 months; and also from the healthcare professionals who are responsible for maternity care to identify the reasons behind the unintended pregnancies, and around Lead Maternity Caregivers' (LMCs') usual practice of postnatal contraceptive provisions, and any barriers to its provision.
  
  
  RESULTS
  22 women were recruited into the study and completed the questionnaire. The majority of women (19) reported that they had discussed contraception with the LMC. However only 4 women were given a prescription for the pill and 2 women were given a prescription for condoms (which was not filled). Almost all women had previously accessed contraception from another provider. 59 LMCs responded. All LMCs reported that they discuss contraception with women, However the majority reported that they discuss contraception with all women at discharge (50) and/or postnatally (49). Only 23 LMCs reported discussing contraception antenatally or at booking.
  
  
  CONCLUSIONS
  Opportunities to intervene are being missed. These include: discussing contraception with all women at booking and/or antenatally; for LMCs to offer prescriptions for contraception to all women and to encourage them to access the supplies, for LMCs to be trained so they feel confident to advise and supply all contraceptive options. Improvements for women could also be made by providing postnatal women with free consultations to her choice of provider, during pregnancy to organise postnatal contraception.
authors.affiliation: Christchurch Women's Hospital, Christchurch, New Zealand. Karen.Joseph@cdhb.govt.nz
authors.forename: Karen
authors.initials: K
authors.lastname: Joseph
authors.forename: Anna
authors.initials: A
authors.lastname: Whitehead
mesh_terms: D000028:Abortion, Induced; D000293:Adolescent; D000328:Adult; D003142:Communication; D003268:Contraception Behavior; D005260:Female; D006801:Humans; D009520:New Zealand; D009721:Nurse Midwives; D010353:Patient Education as Topic; D049590:Postpartum Period; D011247:Pregnancy; D049168:Pregnancy, Unplanned; D012017:Referral and Consultation / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires; D055815:Young Adult