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Contraceptive Use among Abortion Clients of the Atlanta Feminist Women’s Health Center at Three to Five Weeks Post-Abortion Trisha Moslin, MPH tmoslin@prb.org Roger W. Rochat, MD Rollins School of Public Health Hubert Department of Global Health Emory University. Background. About FWHC

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  1. Contraceptive Use among Abortion Clients of the Atlanta Feminist Women’s Health Center at Three to Five Weeks Post-AbortionTrisha Moslin, MPHtmoslin@prb.orgRoger W. Rochat, MD Rollins School of Public Health Hubert Department of Global HealthEmory University

  2. Background • About FWHC • 47% of US women having an AB have had a previous AB1 • Fertility returns within two weeks after an abortion2 • Previous studies3 • 3, 6, 12 months • Qualitative in immediate post-AB period

  3. Research Questions • Are abortion clients using any contraceptive method in the immediate post-abortion period? • Are abortion clients engaging in sexual intercourse in the immediate post-abortion period? • Are abortion clients effectively preventing unintended pregnancy in the immediate post-abortion period? • Can we predict who will use contraception at three to five weeks post-abortion based on demographic variables and variables related to the abortion visit?

  4. Methods • Enrolled during abortion visit at FWHC February 13 to February 27, 2007 >18, English, 1st or 2nd trimester AB, surgical or medical AB, not rape or fetal anomaly, gestation up to 24 weeks and 6 days • Demographic data from client charts • Phone interviews 3 - 5 weeks post-procedure • Data analysis with SAS 9.1 and Excel

  5. Women eligible for study = 161 66% elected to enroll Women who elected to enroll = 106 99% completed the abortion Women who completed the abortion = 105 71% completed phone interview Women who completed the phone interview = 75 Results – Response Rate

  6. Results - Contraceptive Use • 76.0% using contraceptive method • Lower prevalence lower than in other studies  lag time for starting contraception after AB? • Users and non-users did not differ across demographic variables

  7. Contraception Effective 80.0%, n=28 Using Contraception 92.1%, n=35 Contraception Not Effective 20.0%, n=7 Having Sex 54.2%, n=38 Not Using Contraception 7.9%, n=3 Respondents 100%, n=71 Using Contraception 57.6%, n=19 Not Having Sex 45.8%, n=33 Not Using Contraception 42.4%, n=14 Results - Sexual Intercourse and Contraceptive Use

  8. Results - Predicting Contraceptive Use • Outcome – using contraception at the time of the phone interview? • Predictors • Age • Race • Income • Education • Relationship status • Week of gestation the abortion was performed • Prior abortion history • Previous births history • Needed/wanted birth control method/information • Received prescription

  9. Results - Predicting Contraceptive Use • Outcome – using contraception at the time of the phone interview? • Predictors • Age • Race • Income • Education • Relationship status • Week of gestation the abortion was performed • Prior abortion history • Previous births history • Needed/wanted birth control method/information • Received prescription

  10. “__Check if you DO NOT need/want birth control method/information.”

  11. Limitations • Limitations common to other abortion-related studies - low response rate, potential differential participation, questions’ of women’s truthfulness in their answers, recall bias, and measurement bias • Using method at time of phone interview vs. did you use a contraceptive method when you had sexual intercourse

  12. Survey Questions • Are you using any method to prevent pregnancy right now? • What date did you start using [METHOD] after your procedure? • Have you had sexual intercourse since your procedure? 16. What date did you first have sexual intercourse after your procedure?

  13. References • Henshaw, SK. (1999). Unintended Pregnancy and Abortion: A Public Health Perspective. In M Paul et al. (Ed.), A Clinician's Guide to Medical and Surgical Abortion (pp. 11-22). New York: Churchill Livingstone. • Salter, C., Johnston, H. B., & Hengen, N. (1997). Care for Postabortion Complications: Saving Women's Lives. Baltimore, MD: Johns Hopkins School of Public Health. • See “Summary of Relevant Literature” handout

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