Peri-abortion contraception: a qualitative study of users' experiences

BACKGROUND: Contraceptive counselling is an essential element of induced abortion services but concerns remain about its effectiveness. OBJECTIVE: The issues that influence peri-abortion contraception were explored as part of a study on the experiences of women undergoing induced abortion. METHOD: In-depth interviews with 21 women of varying ages, gestations and ethnicity, 3-9 weeks after termination of their pregnancy, with qualitative analysis of data. RESULTS: Contraceptive risk-taking was high both before and after abortion. After abortion, only a few women had changed either to using some method, or moving to more reliable methods. Health professionals had not explored the issues around contraception with sufficient clarity or detail to be effective. Discussion of contraception was often deferred to the post-abortion follow-up visit, which only 12 respondents had attended at the time of interview. CONCLUSIONS: The effectiveness of peri-abortion contraception counselling was disappointing. We suggest that a family planning-trained outreach nurse attached to abortion providers with specific responsibility for contraception could improve uptake post-abortion.