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Rebecca Wind
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PROVIDING POSTABORTION CONTRACEPTIVE SERVICES IS KEY TO REDUCING REPEAT UNINTENDED PREGNANCIES AND ABORTIONS

Yet Many Facilities Face Logistical and Financial Barriers to Providing Extensive Contraceptive Care

Because most abortions result from unintended pregnancies—and many from repeat unintended pregnancies—better access to affordable and effective contraceptive services and supplies for women who obtain abortions should be a high priority. Virtually all abortion providers offer at least some postabortion contraceptive services, yet for many women, the facility at which they obtain an abortion is unable to fully meet their needs.

Two new studies from the Guttmacher Institute examine postabortion contraceptive services, one from the perspective of patients and one focusing on providers. The first, “Patients’ Attitudes and Experiences Related to Receiving Contraception During Abortion Care,” by Megan Kavanaugh et al., finds that two-thirds of women seeking abortion report that they want to leave their appointments with a contraceptive method in hand, and 69% believe that the abortion setting is an appropriate one for receiving contraceptive information. Among women who had had an abortion in the past five years, more than two-thirds had received a method of contraception during their visit.

According to “Perceived and Insurance-Related Barriers to the Provision of Contraceptive Services in U.S. Abortion Care Settings,” also by Megan Kavanaugh et al., comprehensive reproductive health centers that provide abortions offer a wider range of postabortion contraceptive methods than do specialized abortion clinics. In 2008, specialized clinics accounted for 21% of abortion providers but performed 70% of all abortions. Specialized clinics that do not accept health insurance are less likely than other facilities to have highly effective contraceptive methods such as IUDs and implants on site.

Meanwhile, specialized abortion clinics—although they may have difficulty providing full-spectrum and ongoing contraceptive care (because they tend to see women only at the time of their abortion)—may be especially well-suited to provide the most effective contraceptive methods on the market, according to “Abortion Clinics and Contraceptive Services: Opportunities and Challenges,” by Adam Sonfield. Providing long-acting reversible methods, such as IUDs and contraceptive implants, and even surgical sterilization, would be well within their medical expertise. Doing so, however, would require significant financial and institutional investments in order to overcome challenges related to patient demand, the high cost of services and supplies, and the need to interface with public and private insurance systems.

“Patients’ Attitudes and Experiences Related to Receiving Contraception During Abortion Care,” by Megan Kavanaugh et al., is available online and will appear in a forthcoming issue of the journal Contraception. “Perceived and Insurance-Related Barriers to the Provision of Contraceptive Services in U.S. Abortion Care Settings,” by Megan Kavanaugh et al., is currently available online and will appear in a forthcoming issue of the journal Women’s Health Issues. “Abortion Clinics and Contraceptive Services: Opportunities and Challenges,” by Adam Sonfield appears in the Spring issue of the Guttmacher Policy Review.

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