University of Colorado, Department of Obstetrics and Gynecology, 12631 E. 17th Ave., Mailstop B198-2, Aurora, CO 80045, USA.
University of Colorado, Department of Obstetrics and Gynecology, 12631 E. 17th Ave., Mailstop B198-2, Aurora, CO 80045, USA.
Contraception. 2018 Oct;98(4):292-295. doi: 10.1016/j.contraception.2018.06.001. Epub 2018 Jun 11.
The objective was to identify predictors of postabortion long-acting reversible contraception (LARC) initiation to increase providers' understanding of motivators of contraceptive choices.
We prospectively enrolled a cohort of women having abortions at <13 weeks' gestational age who were eligible to receive no-cost contraceptive methods immediately postprocedure (N=1662) to evaluate the demographic and reproductive factors associated with choosing and receiving a long-acting contraceptive versus a short-acting method. We used stepwise logistic regression to identify independent predictors of LARC initiation.
During the study period, 1072 (64.5%) chose an immediate postabortion LARC method and 590 (35.5%) chose another method. Compared to the group of women who chose a non-LARC method, women who chose a LARC method were more likely to have a surgical abortion and were younger, more likely to be Hispanic, more likely to live greater than 70 miles from the clinic, more likely to have a nonurban address and less likely to have had a prior abortion.
We found that the differences in the demographic and reproductive factors of women choosing and receiving postabortion LARC were those which have been shown to be associated with difficulty in accessing contraception. Providers should offer a full range of contraceptive options to women immediately postabortion.
Postabortion LARC is more likely to be utilized by women from groups who have been shown to have difficulty accessing traditional family planning clinical care: those who are young, do not live in a city and are from groups with recognized health disparities. Offering postabortion LARC increases the options for these women.
确定流产后长效可逆避孕（LARC）起始的预测因素，以增加提供者对避孕选择动机的理解。
我们前瞻性地招募了一组在<13 周妊娠年龄行流产且符合条件可在术后立即获得免费避孕方法的女性（N=1662），以评估与选择和接受长效避孕方法与短效方法相关的人口统计学和生殖因素。我们使用逐步逻辑回归来确定 LARC 起始的独立预测因素。
在研究期间，1072 名（64.5%）女性选择了立即流产后 LARC 方法，590 名（35.5%）选择了另一种方法。与选择非 LARC 方法的女性相比，选择 LARC 方法的女性更有可能进行手术流产，且更年轻、更可能是西班牙裔、更可能居住在距离诊所 70 英里以上的地方、更可能居住在非城市地区且不太可能有过流产史。
我们发现，选择和接受流产后 LARC 的女性在人口统计学和生殖因素方面的差异与获得避孕措施的困难有关。提供者应在流产后立即向女性提供各种避孕选择。
流产后 LARC 更有可能被那些被证明难以获得传统计划生育临床护理的女性所利用：年轻、不住在城市且来自存在公认健康差距的群体的女性。提供流产后 LARC 增加了这些女性的选择。
