Use of contraception by women with induced abortion in Italy

Objectives: To investigate type of contraception, if any, used by women with induced abortion. Methods: Retrospective analysis on the medical records of 1782 women with induced abortion performed at the University Hospital of Modena (Italy) between 2009 and 2011. Results: Some kind of contraception was used by 81.1% of women with induced abortion. At time of conception most of these women (39%) had used withdrawal, 19.0% natural methods, 15.2% condom, 7% hormonal contraception (95% estrogen plus progestin for any route) and 0.4% copper-IUD. None was using implants or levonorgestrel-IUD. Figures of past use of hormonal contraception were much higher than those present at the time of the unwanted pregnancy (50.3% vs. 7%; p<0.0001). A higher prevalence of condom use (19.7% vs. 10.9%; p<0.0001), and a lower prevalence of natural methods (14.5% vs. 21.6%; p<0.001) were found in single vs. married women. Use of no contraception was more prevalent among low vs. highly educated women with induced abortion (22.2% vs. 14.2%; p<0.02), but was not related to marital status. Prevalence of use of the different contraceptives is different from the one described in the general population, suggesting differences in contraceptive efficacy among the different methods. Conclusions: Women with induced abortion infrequently use long term or hormonal contraception. In half of the cases the latter has been used at least once in life, but then it has been abandoned. Appropriate education and contraceptive counselling, personalization and follow-up may reduce induced abortion.