Study: Give Contraceptive Implants After Delivery or Abortion

Unintended pregnancy can have serious repercussions for young women, especially if it happens repeatedly.  One teen mother in four gets pregnant again within two years, and each additional birth reduces her chances of finishing high school and avoiding poverty.  Recurring unintended pregnancies pose risks for adult women as well, and many end in abortion.  Preventing these pregnancies is a central challenge in women’s health, and two new studies show how long-acting contraceptives could help address it.  In studies presented today, researchers showed that contraceptive implants could safely help prevent repeated unintended pregnancies if women received them immediately after giving birth or having an abortion.  The findings were released at the North American Forum on Family Planning, a scientific meeting sponsored by Planned Parenthood Federation of America (PPFA) and the Society of Family Planning (SFP).

In one study, researchers at the University of Colorado School of Medicine followed 396 young women participating in an adolescent maternity program who gave birth over a one-year period.  The participants, all 13 to 23 years old, were offered their choice of contraceptives before leaving the hospital.  When given the option, 171 of them (43 percent) chose a matchstick-size implant (Implanon) that provides three years of protection when placed under the skin in the arm.  The others selected shorter-acting methods or declined the offer.  After 12 months, fewer than three percent of the implant recipients had become pregnant again.  The rate was 19 percent — some seven times higher — in the comparison group.

“This is tremendously encouraging,” says Dr. Kristina Tocce, the physician who led the study.  “Almost half of these young women opted to receive the implant immediately.  Most of those who chose this method stuck with it, and it worked.  The finding should set the stage for larger, randomized trials.  Postpartum implants have the potential to help many young women avoid repeated teen pregnancies and births.”

In a separate study, researchers at Boston Medical Center found that the contraceptive implant could be an effective and desirable way for women receiving abortions to prevent additional unintended pregnancies.  In the Boston study, Dr. Alice Mark and her colleagues followed 103 implant users and compared continuation rates between two groups:  those who received the implant during a routine gynecological visit, and those who received it immediately after terminating a pregnancy.

A woman receiving an abortion almost always receives information and counseling about birth control options, but she normally has to schedule a separate appointment if she wants to start a long-acting method like the implant.  This extra step keeps some women from receiving these highly effective options, so the Boston researchers sought to eliminate it.  Their study was set up to determine whether women who received their implants during abortion visits would be less satisfied with them — and more likely to remove them within 12 months — than women who received them at other times.

The results showed no such downside.  Women who received implants immediately after terminating pregnancies had roughly the same continuation rate as the women in the comparison group.  And, though 24 percent of all participants discontinued the method during the yearlong study, the post-abortion patients kept their implants longer (186 days on average) than those in the routine-care group (roughly 129 days).

“Our findings suggest that the contraceptive implant can provide safe, effective, well-accepted birth control for the women who are most likely to benefit from it,” Mark says.  “The high initial cost is still a barrier for some of these women, but as health care reform eliminates co-pays for contraceptives, post-abortion implants could help many who have had difficulty sustaining shorter-acting methods such as the pill.”


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