title: Postabortion Initiation of Long-Acting Reversible Contraception by Adolescent and Nulliparous Women in New Zealand.
abstract: OBJECTIVE
  To describe changes in receipt of immediate postabortion long-acting reversible contraception (LARC) by adolescent and nulliparous women in New Zealand.
  
  
  METHODS
  Nationally collected data on immediate postabortion receipt of an intrauterine method (intrauterine device [IUD]/intrauterine system [IUS]) or contraceptive implant were analyzed to describe proportions and demographic characteristics of women receiving LARC between 2007 and 2013. Changes in uptake over time were presented for adolescent, nulliparous, and parous women.
  
  
  RESULTS
  Postabortion LARC uptake increased between 2007 and 2013, rising from 7.9% to 42.7% for adolescents and from 8.8% to 36.9% for nulliparous women. The increase was highest among nulliparous adolescents with a seven-fold increase in LARC uptake between 2007 and 2013. Adolescents had a five-fold increase and nulliparous women (of all ages) a four-fold increase. In 2013, IUD/IUS use was lowest among adolescents (22.4%) and increased with increasing age (43% by ages 40+ years), whereas implant use was highest among adolescents (20.3%) and decreased with increasing age (to 4.6% by age 40+ years). Nulliparous women had the lowest use of both IUD/IUS and implants in 2013, with 24.6% receiving an intrauterine method (compared with 43.2% for para 3+), and 12.3% an implant (compared with 17.5% for para 3+).
  
  
  CONCLUSIONS
  Despite an overall trend toward increased uptake of postabortion LARC by adolescent and nulliparous women, uptake in these groups still lags behind that of parous and older women. Reasons for differential uptake need to be explored and addressed if necessary to ensure all women have equitable access to the most effective methods of contraception.
authors.affiliation: Department of Primary Health Care and General Practice, University of Otago, Wellington, Wellington South, New Zealand. Electronic address: sally.rose@otago.ac.nz.
authors.forename: Sally B
authors.initials: SB
authors.lastname: Rose
authors.affiliation: Department of Primary Health Care and General Practice, University of Otago, Wellington, Wellington South, New Zealand.
authors.forename: Susan M
authors.initials: SM
authors.lastname: Garrett
mesh_terms: D000028:Abortion, Induced / Q000706:statistics & numerical data; D000293:Adolescent; D000328:Adult; D000359:Aftercare / Q000379:methods*; D003267:Contraception / Q000379:methods / Q000706:statistics & numerical data*; D003271:Contraceptive Agents, Female / Q000008:administration & dosage; D003692:Delayed-Action Preparations; D005260:Female; D006801:Humans; D007434:Intrauterine Devices / Q000706:statistics & numerical data*; D009520:New Zealand; D010298:Parity; D011247:Pregnancy; D055815:Young Adult
chemical_list: D003271:Contraceptive Agents, Female; D003692:Delayed-Action Preparations
keywords: Adolescents; Induced abortion; Intrauterine devices; Long-acting reversible contraception (LARC); Pregnancy prevention; Subdermal implants; Unintended pregnancy