Background/introduction Almost half of pregnancies in England were estimated to be unplanned or ambivalent, and a fifth resulted in abortions. Uptake of non-injectable long-acting reversible contraception (NI-LARC) methods is recommended to reduce the risk of unplanned pregnancies and abortions.
Aim(s)/objectives To determine if NI-LARC usage reduces the risk of abortion.
Methods Attendances at Sexual and Reproductive Health (SRH) services which provided more than 10 abortions during 1/1/2013–31/12/2014, recorded in the SRH Activity Dataset, were considered. The risk of abortion by contraceptive method (NI-LARC, other methods) used at least once or no method during the study period, was estimated using the Kaplan-Meier method. Cox Proportional Hazards Models were used to estimate hazard ratios for risk of abortion by contraceptive method used, adjusted for age, ethnicity, area-level deprivation and rural/urban residence.
Results 42,210 women used NI-LARC (26.2%), 79,380 women used other contraceptive methods (49.3%), 39,403 women had no method (24.5%); 2,339 women had an abortion (1.5%). The highest proportion of women who had an abortion was reached within first month of exposure: 0.08% of women using NI-LARC, 1.34% of those using other contraceptive methods and 2.63% of those not on contraception. The adjusted hazard ratios for risk of abortions were 17.5 (CI 13.1–23.4) times higher in women who were not on contraception and 12.6 (9.5–16.9) times higher in women using other contraceptive methods, compared to those who used NI- LARC.
Discussion/conclusion NI-LARC use is strongly associated with reduced risk of abortion in women attending SRH services because it is independent of compliance.
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