Postabortion Contraceptive Counseling Can Help Individuals Prevent Future Unintended Pregnancies

In 2014, about half (51%) of abortion patients in the United States reported that they had used a contraceptive method in the month they became pregnant, according to a new analysis by Guttmacher researcher Rachel Jones. This proportion represents a slight decrease from 54% of abortion patients in 2000, the last time these data were examined. The methods most commonly used by abortion patients in 2014 were condoms (24% of patients) and the pill (13%).

“Contraceptive methods are highly effective at preventing unintended pregnancies, but no method—and no user—is perfect,” says Rachel Jones, author of the analysis. “Abortion patients should have access to the full range of contraceptive counseling and services to support them in preventing future unintended pregnancies.”

Jones analyzed responses to the Guttmacher Institute’s 2000 and 2014 Abortion Patient Survey to determine which contraceptive method or methods U.S. abortion patients had been using during the month they became pregnant. Although the demographic characteristics of abortion patients changed substantially between 2000 and 2014, these new findings suggest that contraceptive use patterns among abortion patients were similar in both years.

The share of abortion patients relying on condoms decreased between 2000 and 2014 (from 28% to 24%), and there was a small but significant increase in the share of patients who relied on withdrawal (from 7% in 2000 to 9% in 2014). Use of long-acting reversible contraceptive (LARC) methods among abortion patients increased from 0.1% in 2000 to 1% in 2014. Jones notes that as more and more U.S. women rely on these methods, a larger number of individuals will experience method failure. It is also possible that some abortion patients became pregnant shortly after they stopped using LARCs or other contraceptive methods.

Abortion patients who were using contraception at the time they became pregnant account for a very small proportion of all U.S. contraceptive users. In 2014, about 37.8 million U.S. women aged 15–44 were using a contraceptive method. In contrast, only 471,000 abortions were provided to patients who reported they were using contraception in the month they became pregnant. Between 2000 and 2014, the overall number of abortions in the United States declined significantly, and available evidence suggests that improvements in contraceptive use contributed to the abortion decline.  

Although no contraceptive method is perfect, evidence from decades of research has found that contraception is effective at pregnancy prevention and it has numerous health, social and economic benefits. The analysis notes that abortion patients who were not using contraception at the time they became pregnant may benefit from receiving information during postabortion counseling about their risk of pregnancy, and all abortion patients could benefit from receiving information about the full range of contraceptive options available to them and how to use those methods consistently and correctly.

“For many people seeking abortion care, having access to contraceptive services at the time of their procedure simply makes sense,” says Heather Boonstra, Guttmacher policy expert. “The fact that most abortions result from unintended pregnancy underscores the importance of ensuring patients are fully informed about their contraceptive options and get the ongoing contraceptive care they need.”

Reported Contraceptive Use in the Month of Becoming Pregnant among U.S. Abortion Patients in 2000 and 2014,” by Rachel Jones, is currently available online and will appear in a forthcoming issue of Contraception.

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