What proportion of Canadian women will accept an intrauterine contraceptive at the time of second trimester abortion? Baseline data from a randomized controlled trial.
OBJECTIVE
This report details enrolment findings related to a Canadian randomized controlled trial comparing immediate to delayed intrauterine contraception (IUC) placement after a second trimester abortion. We report acceptance of IUC, satisfaction with prior contraception, adherence to the CONSORT criteria, and challenges faced in the recruitment process.


METHODS
Women seeking second trimester abortion and selecting either of two methods of IUC as their preferred contraception method were enrolled and randomized to insertion either immediately post-abortion or four weeks later. Enrolled participants completed a Contraception Satisfaction Questionnaire detailing prior contraceptive satisfaction.


RESULTS
Among 1813 women assessed, 1500 (83%) met eligibility criteria and IUC was chosen for post-abortion contraception by over one half of them (792/1500, 53%). When both types of device were available cost-free, women selected the levonorgestrel-releasing intrauterine system more than 20 times more frequently than a copper IUD. Participants had an average age of 26.0 (standard deviation [SD] 6.8) years, and an average gestational age of 16.1 (SD 3.1) weeks. Almost one half (48.4%) had had a prior abortion and 46.9% had a prior delivery. Two thirds of participants were using a contraception method at the time of conception, but almost one third of these were using methods in the lowest tiers of effectiveness. There was a weak correlation between prior contraceptive compliance and education level.


CONCLUSIONS
More than one half of eligible women seeking a second-trimester abortion chose IUC for post-abortion contraception. In Canada, health care for unintended pregnancies is universally subsidized but contraception is not. Offering comprehensive information on the range of contraceptive methods and providing cost-free IUC is an effective strategy to increase uptake of intrauterine contraception among Canadian women who wish to prevent further unintended pregnancy.
Contraception Access Research Team-Groupe de recherché sur l'accessibilité à la contraception, Women's Health Research Institute, British Columbia Women's Hospital and Health Centre, Vancouver BC; Department of Family Practice, University of British Columbia, Vancouver, BC.
Wendy V
WV
Norman
Contraception Access Research Team-Groupe de recherché sur l'accessibilité à la contraception, Women's Health Research Institute, British Columbia Women's Hospital and Health Centre, Vancouver BC; Department of Obstetrics and Gynaecology, Dalhousie University, Halifax NS.
Melissa
M
Brooks
Contraception Access Research Team-Groupe de recherché sur l'accessibilité à la contraception, Women's Health Research Institute, British Columbia Women's Hospital and Health Centre, Vancouver BC; Department of Statistics, University of British Columbia, Vancouver, BC.
Rollin
R
Brant
Contraception Access Research Team-Groupe de recherché sur l'accessibilité à la contraception, Women's Health Research Institute, British Columbia Women's Hospital and Health Centre, Vancouver BC; Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, BC.
Judith A
JA
Soon
Faculty of Science, University of British Columbia, Vancouver, BC.
Ali
A
Majdzadeh
Contraception Access Research Team-Groupe de recherché sur l'accessibilité à la contraception, Women's Health Research Institute, British Columbia Women's Hospital and Health Centre, Vancouver BC; Département de médecine de famille et de médecine d'urgence, Université de Montréal, Montreal, QC.
Janusz
J
Kaczorowski
D000028:Abortion, Induced; D000328:Adult; D002170:Canada; D004522:Educational Status; D005260:Female; D006801:Humans; D007182:Income; D007434:Intrauterine Devices; D007435:Intrauterine Devices, Copper; D007436:Intrauterine Devices, Medicated; D016912:Levonorgestrel; D010342:Patient Acceptance of Health Care; D017060:Patient Satisfaction; D011247:Pregnancy; D011262:Pregnancy Trimester, Second
D016912:Levonorgestrel
Canada; abortion; family planning; health services; induced; sexual health