Background/introduction Despite free contraception in Scotland, over 12,000 terminations of pregnancy (TOP) are carried out annually at great financial cost.
Aim(s)/objectives To quantify methods of contraception in women presenting with unintended pregnancy at a large urban integrated sexual health unit, to identify reasons for failure.
Methods A retrospective case note review of a random sample of 100 women attending termination referral services between October 2013–March 2014.
Results Of attendees, mean age was 26 years. 38% had used male condoms. 35% “no contraception”. 25% Oral contraceptive pill. 24% of condom users and 43% of COCP reported imperfect use. Additionally, 9% fell pregnant despite reported use of emergency contraception. 45% had undergone at least one therapeutic termination previously, of these: 22% reporting no use of contraception at time of conception. 4% no contraception ever. 44% of repeat attenders and 28% of whole sample reported using LARC methods in the past. 63% of women stated intention to undertake a LARC method post-procedure, however it is not clear if these were implemented.
Discussion/conclusion Large numbers of repeat TOPs suggests problems with uptake of reliable contraception post-procedure. Counselling at initial consultation – especially for repeat attendees; specific post-termination clinics and support; interventions and education targeted at high risk groups; and advocated use of LARC should reduce repeat procedures. LARC methods of contraception should continue to be encouraged in all females for primary prevention given their extreme effectiveness. Future studies of the actual uptake versus stated intention to use LARC may be insightful.
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