European Journal of Contraception and Reproductive Health Care
Volume 22, Issue 1, 2017, Pages 38-44

Why prevention of repeat abortion is so challenging: psychosocial characteristics of women at risk (Article)

Leeners B. , Bieli S. , Huang D. , Tschudin S.*
  • a Clinic for Reproductive Endocrinology, University Hospital of Zürich, Zürich, Switzerland
  • b Faculty of Medicine, University of Basel, Basel, Switzerland, Aarau, Switzerland
  • c Division of Social Medicine and Psychosomatics, Department of Obstetrics and Gynaecology, University Hospital of Basel, Basel, Switzerland
  • d Division of Social Medicine and Psychosomatics, Department of Obstetrics and Gynaecology, University Hospital of Basel, Basel, Switzerland

Abstract

Objectives: Abortion rates have declined in recent decades; however, the rate of repeat abortion remains high. In order to identify keys to making efficient interventions against repeat abortion, our objectives were: to assess the percentage of repeat abortions in women opting for termination of pregnancy over a period of 1 year; to identify the risk factors for repeat abortion; and to assess the characteristics of women who opted for a further pregnancy termination despite having received standard post-abortion care. Methods: A retrospective cross-sectional survey was carried out among 362 women who underwent pregnancy termination during a 1-year period. Women with and without repeat abortion were compared with regard to age, nationality, marital status, parity and use of contraception. In a subsample of 160 women who were available for follow-up over 4 years, those who underwent a further pregnancy termination during the observation period were also analysed qualitatively. Results: The rate of repeat abortion was 30.1% in the survey population. Age and immigrant status were identified as risk factors. The use of long-acting reversible contraception (LARC) was significantly higher after repeat abortion than after a first termination of pregnancy. Among women with repeat abortion in the follow-up group, those with psychological problems tended to discontinue contraception and those with partnership conflicts were prone to using unreliable contraceptive methods. Conclusion: Aside from promoting LARC methods, strategies to reduce repeat abortion should consider the psychosocial risk factors and characteristics of women at risk identified in this study. An interdisciplinary approach including social care and counselling would be the most appropriate means to enable this. © 2016 The European Society of Contraception and Reproductive Health.

Author Keywords

immigrants termination of pregnancy repeat abortion risk factors Contraception

Index Keywords

induced abortion Abortion, Induced immigrant social psychology health care survey conflict follow up long acting drug human statistics and numerical data priority journal Marital Status procedures qualitative research Cross-Sectional Studies marriage Young Adult cross-sectional study Humans psychology female risk factor Risk Factors Contraception qualitative analysis pregnancy contraceptive agent Article Retrospective Studies major clinical study adult age Age Factors parity retrospective study contraceptive behavior Contraception Behavior

Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-85000349754&doi=10.1080%2f13625187.2016.1258053&partnerID=40&md5=ccaabe89e38c98e47f998e831a83457e

DOI: 10.1080/13625187.2016.1258053
ISSN: 13625187
Cited by: 6
Original Language: English