Bryant Amy G, Speizer Ilene S, Hodgkinson Jennifer C, Swiatlo Alison, Curtis Siân L, Perreira Krista
From the Department of Obstetrics and Gynecology, Division of Family Planning, University of North Carolina School of Medicine, the Department of Maternal and Child Health, University of North Carolina Gillings School of Global Public Health, the Cecil G. Sheps Center for Health Services Research, University of North Carolina, and the Department of Social Medicine, University of North Carolina School of Medicine, Chapel Hill.
South Med J. 2018 Jun;111(6):317-323. doi: 10.14423/SMJ.0000000000000820.
Abortion clinics provide an ideal setting for women to receive contraceptive care because the women served may not have other contacts with the health system and are at risk for unintended pregnancies. The objective of this study was to understand practices, preferences, and barriers to use of contraception for women obtaining abortions at clinics in North Carolina.
We conducted a cross-sectional survey of abortion clients and facilities at 10 abortion clinics in North Carolina. We collected data on contraceptive availability at each clinic. We collected individual responses on women's experiences obtaining contraception before the current pregnancy and their intentions for future use of contraception.
From October 2015 to February 2016, 376 client surveys were completed at 9 clinics, and 10 clinic surveys were completed. Almost one-third of women (29%) reported that they had wanted to use contraception in the last year but were unable. Approximately three-fourths of respondents (76%) stated that they intend to use contraception after this pregnancy. Approximately one-fifth of women stated that would like to use long-acting reversible contraception (LARC) after this abortion. Only the clinics that accepted insurance for abortion and other services provided LARC at the time of the abortion (40%).
This study provides a unique, statewide view into the contraceptive barriers for women seeking abortion in North Carolina. Addressing the relatively high demand for LARC after abortion could help significantly reduce unintended pregnancy and recourse to abortion in North Carolina.
堕胎诊所为女性提供了接受避孕护理的理想场所，因为前来就诊的女性可能与医疗系统没有其他接触，且面临意外怀孕的风险。本研究的目的是了解北卡罗来纳州诊所中接受堕胎手术的女性在避孕措施使用方面的做法、偏好和障碍。
我们对北卡罗来纳州10家堕胎诊所的堕胎客户和诊所设施进行了横断面调查。我们收集了每家诊所的避孕措施供应数据。我们收集了关于女性在本次怀孕前获取避孕措施的经历以及她们未来避孕打算的个人反馈。
2015年10月至2016年2月，在9家诊所完成了376份客户调查，10份诊所调查也已完成。近三分之一的女性（29%）报告称，她们在过去一年想使用避孕措施但未能如愿。约四分之三的受访者（76%）表示，她们打算在本次怀孕后使用避孕措施。约五分之一的女性表示，她们在本次堕胎后希望使用长效可逆避孕法（LARC）。只有那些接受堕胎及其他服务保险的诊所才在堕胎时提供LARC（40%）。
本研究为北卡罗来纳州寻求堕胎的女性的避孕障碍提供了独特的全州范围视角。满足堕胎后对LARC相对较高的需求，有助于显著减少北卡罗来纳州的意外怀孕和堕胎需求。
