title: Likelihood of repeat abortion in a Swedish cohort according to the choice of post-abortion contraception: a longitudinal study.
abstract: BACKGROUND
  Despite high access to contraceptive services, 42% of the women who seek an abortion in Sweden have a history of previous abortion(s). The reasons for this high repeat abortion rate remain obscure. The objective of this study was to study the choice of contraceptive method after abortion and related odds of repeat abortions within 3-4 years.
  
  
  METHODS
  This is a retrospective cohort study based on a medical record review at three hospitals in Sweden. We included 987 women who had an abortion during 2009. We reviewed medical records from the date of the index abortion until the end of 2012 to establish the choice of contraception following the index abortion and the occurrence of repeat abortions. We calculated odds ratios (OR) with 95% CI.
  
  
  RESULTS
  While 46% of the women chose oral contraceptives, 34% chose long-acting reversible contraceptives (LARC). LARC was chosen more commonly by women with a previous pregnancy, childbirth and/or abortion. During the follow-up period, 24% of the study population requested one or more repeat abortion(s). Choosing LARC at the time of the index abortion was associated with fewer repeat abortions compared with choosing oral contraceptives (13% vs. 26%, OR 0.36; 95% CI 0.24-0.52). Subdermal implant was as effective as intrauterine device in preventing repeat abortions beyond 3 years.
  
  
  CONCLUSIONS
  Choosing LARC was associated with fewer repeat abortions over more than 3 years of follow up.
authors: Department of Medical and Health Sciences, Linköping University, Linköping, Sweden.|Department of Obstetrics and Gynecology, Region Jönköping County, Jönköping, Sweden.
authors: Helena
authors: http://orcid.org/0000-0003-3597-9004
authors: H
authors: Kilander
authors: Department of Medical and Health Sciences, Linköping University, Linköping, Sweden.
authors: Siw
authors: http://orcid.org/0000-0003-0248-7441
authors: S
authors: Alehagen
authors: Department of Medical and Health Sciences, Linköping University, Linköping, Sweden.
authors: Linnea
authors: http://orcid.org/0000-0003-2038-6337
authors: L
authors: Svedlund
authors: Department of Obstetrics and Gynecology, Vrinnevis Hospital, Norrköping, Sweden.
authors: Karin
authors: http://orcid.org/0000-0002-5365-2796
authors: K
authors: Westlund
authors: Jönköping Academy for Improvement of Health and Welfare, Jönköping University, Jönköping, Sweden.
authors: Johan
authors: http://orcid.org/0000-0003-1814-4478
authors: J
authors: Thor
authors: Department of Obstetrics and Gynecology and Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden.
authors: Jan
authors: http://orcid.org/0000-0002-0071-4383
authors: J
authors: Brynhildsen
mesh_terms: D000026:Abortion, Habitual / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control; D000028:Abortion, Induced / Q000009:adverse effects / Q000706:statistics & numerical data; D000328:Adult; D015331:Cohort Studies; D003267:Contraception / Q000009:adverse effects / Q000706:statistics & numerical data; D003271:Contraceptive Agents, Female / Q000008:administration & dosage / Q000009:adverse effects; D005260:Female; D006801:Humans; D007434:Intrauterine Devices / Q000009:adverse effects / Q000706:statistics & numerical data; D008137:Longitudinal Studies; D011247:Pregnancy; D017584:Reproductive History; D013548:Sweden / Q000453:epidemiology
chemical_list: D003271:Contraceptive Agents, Female
keywords: Long-acting reversible contraception; post-abortion contraception; repeat abortion; subdermal implant; termination of pregnancy