Facilitators and barriers to long acting reversible contraceptives within twelve weeks post-abortion in an outpatient abortion clinic in Atlanta, Georgia. Open Access

Abstract

Objective: Post-abortion, many women consider switching to or starting a new contraceptive method. This study aims to characterize factors that affect uptake of a long acting reversible contraceptive (LARC) post-abortion in women from the southeastern United States.

Study Design and Setting: 126 English-speaking women aged 18 years or older completed a baseline survey on the day of their elective 1^st or 2^nd trimester surgical abortion at the Atlanta Women's Center. Bivariate associations between uptake of LARC and predictors were examined using logistic regression. Unadjusted odds ratios (ORs) and 95% confidence intervals (CIs) are reported.

Results: The majority of women in the population identified as black (61.2%), single (75.9%), employed full-time (54.8%) with private insurance (47.3%) who had less than 3 children in their household (80.9%). Fifteen of the 126 women began a LARC method within 12-weeks (12%) post-abortion. Those that started a LARC method were more likely to be a full time student (OR 4.0; 95% CI 1.2, 13.1), married or cohabitating (OR 4.6; 95% CI 1.4, 15.0) have a pre-counseling interest in starting a LARC method (OR 8.6; 95% CI 2.7, 28.7), and have heard of the contraceptive implant from a friend (OR 4.8; 95% CI 1.2, 19.5). Women who started a LARC method did not differ significantly from those who did not uptake LARC by age, ethnicity, education level, gravidity, parity, or prior abortion status.

Conclusions: Within 12 weeks post abortion, women uptake LARC methods at a high proportion compared with national prevalence, with some indication that social influence prior to the clinic visit playing a role.

Table of Contents

Chapter I - Background/Literature Review...............................................1

Abortion and Contraception in the United States.....................................1

The Importance of LARC Method Use Post-Abortion................................2

Factors that Affect LARC Uptake Post-Abortion.......................................6

References............................................................................................7

Chapter II - Manuscript.........................................................................12

A. Title, Authors, Abstract.....................................................................12

B. Introduction.....................................................................................13

C. Methods...........................................................................................15

D. Results.............................................................................................17

E. Discussion........................................................................................19

F. Conclusions......................................................................................22

G. References........................................................................................23

H. Tables..............................................................................................26

Chapter III - Summary/Public Health Implications/Possible Future Directions...........29

Summary..............................................................................................29

Public Health Implications ....................................................................29

Future Directions..................................................................................31

References............................................................................................32

About this Master's Thesis

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• Permission granted by the author to include this thesis or dissertation in this repository. All rights reserved by the author. Please contact the author for information regarding the reproduction and use of this thesis or dissertation.

School	Rollins School of Public Health
Department	Epidemiology
Subfield / Discipline	Global Epidemiology - MPH & MSPH
Degree	MPH
Submission	Master's Thesis
Language	English
Research Field	Health Sciences, Public Health Psychology, Behavioral Health Sciences, Epidemiology
Keyword	contraception abortion LARC IUD
Committee Chair / Thesis Advisor	Wall, Kristin, Emory University
Committee Members	Haddad, Lisa, Emory University
Partnering Agencies	Hospital or other health care provider

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