title: Effect of previous induced abortions on postabortion contraception selection.
abstract: OBJECTIVE
  The objective was to compare contraceptive method selection in women undergoing their first pregnancy termination versus women undergoing repeat pregnancy termination in an urban abortion clinic. We hypothesized that women undergoing repeat abortions will select highly effective contraceptives (intrauterine device, subdermal implant, tubal ligation) more often than patients undergoing their first abortion.
  
  
  METHODS
  We conducted a retrospective analysis of all women undergoing first-trimester surgical abortion at John H. Stroger, Jr., Hospital of Cook County from October 1, 2009, to October 31, 2011. We compared contraceptive method selection in the postabortion period after receipt of contraceptive counseling for 7466 women, stratifying women by history of no prior abortion versus one or more abortions.
  
  
  RESULTS
  Of the 7466 women, 48.6% (3625) had no history of previous abortion. After controlling for age, race and number of living children, women with a history of abortion were more likely to select a highly effective method [odds ratio (OR) 1.19, 95% confidence interval (CI) 1.06-1.33]. Most significantly, having living children was the strongest predictor of a highly effective method with an OR of 3.17 (95% CI 2.69-3.75).
  
  
  CONCLUSIONS
  In women having a first-trimester abortion, the factors most predictive of selecting a highly effective method for postabortion contraception include history of previous abortion and having living children. The latter holds true independent of abortion history.
  
  
  CONCLUSIONS
  This paper is unique in its ability to demonstrate the high interest in highly effective contraceptive selection in high-risk, low-income women with prior abortion history. Efforts to integrate provision of highly effective methods of contraception for postabortion care are essential for the reduction of future unintended pregnancies.
authors: Department of Obstetrics and Gynecology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA; Division of Family Planning, Department of Obstetrics and Gynecology, John H. Stroger, Jr. Hospital of Cook County, Chicago, IL, USA.
authors: Melissa
authors: M
authors: Keene
authors: Division of Family Planning, Department of Obstetrics and Gynecology, John H. Stroger, Jr. Hospital of Cook County, Chicago, IL, USA.
authors: Alicia
authors: A
authors: Roston
authors: Department of Obstetrics and Gynecology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA; Division of Family Planning, Department of Obstetrics and Gynecology, John H. Stroger, Jr. Hospital of Cook County, Chicago, IL, USA.
authors: Louis
authors: L
authors: Keith
authors: Department of Obstetrics and Gynecology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA; Division of Family Planning, Department of Obstetrics and Gynecology, John H. Stroger, Jr. Hospital of Cook County, Chicago, IL, USA. Electronic address: Apatel2@cookcountyhhs.org.
authors: Ashlesha
authors: A
authors: Patel
mesh_terms: D000023:Abortion Applicants / Q000706:statistics & numerical data*; D000028:Abortion, Induced; D000293:Adolescent; D000328:Adult; D002648:Child; D003267:Contraception / Q000145:classification*; D003270:Contraceptive Agents / Q000008:administration & dosage*; D005193:Family Planning Services; D005260:Female; D006801:Humans; D007434:Intrauterine Devices; D008875:Middle Aged; D011247:Pregnancy; D012189:Retrospective Studies; D013246:Sterilization, Tubal; D055815:Young Adult
chemical_list: D003270:Contraceptive Agents
keywords: Contraception; Family planning; Long-acting reversible contraception; Postabortion; Repeat abortion