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How commonly do US abortion clinics offer contraceptive services?

      Abstract

      Background

      About half of US women having abortions have already had at least one prior abortion. Facilitating access to contraception may help these women avoid subsequent unintended pregnancies. Information is needed to document the availability of contraceptive services in abortion care settings in the United States.

      Study Design

      Data for this cross-sectional mixed-methods study were collected between December 2008 and September 2009 and come from two sources: 15 semistructured telephone interviews and 173 structured questionnaires administered to a nationally representative sample of eligible facilities. Respondents were administrators at large (400+ abortions per year), nonhospital facilities that provide abortion services in the United States.

      Results

      Virtually all (96%) abortion clinics incorporate contraceptive education into abortion care, and the three most common methods reported to be distributed are the birth control pill (99%), the vaginal ring (61%) and Depo-Provera (58%). Almost one-third reported being able to offer post-abortion intrauterine device insertion. Most facilities (82%) accept some form of insurance for either contraceptive or abortion services, and those with a broader family planning focus are significantly more likely to do so. Administrators at the majority of facilities (56%) report that patients most commonly do not pay additional fees for contraceptive services because they are included in the cost of abortion services.

      Conclusion

      Although almost all large, non-hospital abortion providers in the United States are able to provide some level of contraceptive care to their abortion patients, the degree to which they are able to do so is influenced by a wide range of factors.

      Keywords

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      References

        • Jones R.K.
        • Darroch J.E.
        • Henshaw S.K.
        Contraceptive use among U.S. women having abortions in 2000-2001.
        Perspect Sex Reprod Health. 2002; 34: 294-303
        • Jones R.K.
        • Singh S.
        • Finer L.B.
        • Frohwirth L.F.
        Repeat abortion in the United States.
        Guttmacher Institute, New York2006 (Report No.: 29. 65p)
        • Cohen S.A.
        Repeat abortion, repeat unintended pregnancy, repeat and misguided government policies.
        Guttmacher Policy Rev. 2007; 10: 8-12
        • Jones R.K.
        • Zolna M.R.
        • Henshaw S.K.
        • Finer L.B.
        Abortion in the United States: incidence and access to services, 2005.
        Perspect Sex Reprod Health. 2008; 40: 6-16
        • Grimes D.A.
        Intrauterine devices (IUDs).
        in: Hatcher R.A. Trussell J. Stewart F.H. Nelson A.L. Cates W. Guest F. Contraceptive technology. Ardent Media, Inc, New York2004: 490-521
        • Westhoff C.
        • Heartwell S.
        • Edwards S.
        • et al.
        Initiation of oral contraceptives using a quick start compared with a conventional start: a randomized controlled trial.
        Obstet Gynecol. 2007; 109: 1270-1276
        • Polis C.B.
        • Schaffer K.
        • Blanchard K.
        • Glasier A.
        • Harper C.C.
        • Grimes D.A.
        Advance provision of emergency contraception for pregnancy prevention: a meta-analysis.
        Obstet Gynecol. 2007; 110: 1379-1388
        • Goodman S.
        • Hendlish S.K.
        • Reeves M.F.
        • Foster-Rosales A.
        Impact of immediate postabortal insertion of intrauterine contraception on repeat abortion.
        Contraception. 2008; 78: 143-148
        • L��hteenm��ki P.
        Postabortal contraception.
        Ann Med. 1993; 25: 185-189
        • Ferreira A.L.
        • Lemos A.
        • Figueiroa J.N.
        • de Souza A.I.
        Effectiveness of contraceptive counselling of women following an abortion: a systematic review and meta-analysis.
        Eur J Contracept Reprod Health Care. 2009; 14: 1-9
        • Moos M.K.
        • Bartholomew N.E.
        • Lohr K.N.
        Counseling in the clinical setting to prevent unintended pregnancy: an evidence-based research agenda.
        Contraception. 2003; 67: 115-132
        • O'Connell K.
        • Jones H.E.
        • Simon M.
        • Saporta V.
        • Paul M.
        • Lichtenberg E.S.
        First-trimester surgical abortion practices: a survey of National Abortion Federation members.
        Contraception. 2009; 79: 385-392