Effectiveness of contraceptive counselling of women following an abortion: a systematic review and meta-analysis

Abstract

There was no evidence indicating that contraceptive counselling is effective in increasing acceptance and use of contraceptive methods after an abortion. This may not apply to developing countries, where the matter still needs to be investigated.

Repeat Abortions in New York City, 2010

“…The majority of US abortion providers offer contraception counseling (96 %) or oral contraceptive pills (99 %) at the abortion visit, 21 but contraceptive counseling, alone without providing a contraceptive method, is ineffective at preventing future unplanned pregnancy and abortion. 22,23 The American College of Obstetricians and Gynecologists recommends offering long-acting reversible contraceptives (LARC) as first-line contraception for most women, and adopting same day insertion protocols for surgical abortions. [24][25][26] However, fewer than one third of US providers offer immediate postabortion LARC.…”

Understanding women's desires for contraceptive counseling at the time of first-trimester surgical abortion

“…Theoretically, contraceptive counseling at the time of abortion should reduce the rate of unintended pregnancies and repeat abortions, but effectiveness is difficult to evaluate. Clinical trials and literature reviews from both the United States and Europe over the past decade have failed to show any benefit of highly specialized counseling as compared to routine counseling in the uptake of highly effective contraceptive methods [4] and in the reduction of unintended pregnancy rates or repeat abortions [5,6]. Most notable is a randomized trial from the United Kingdom which found that specialists' contraceptive advice and enhanced provision increased contraceptive uptake, in particular the use of long-acting methods, but did not reduce repeat abortion rates over the following 2 years [6].…”

“…Clinical trials and literature reviews from both the United States and Europe over the past decade have failed to show any benefit of highly specialized counseling as compared to routine counseling in the uptake of highly effective contraceptive methods [4] and in the reduction of unintended pregnancy rates or repeat abortions [5,6]. Most notable is a randomized trial from the United Kingdom which found that specialists' contraceptive advice and enhanced provision increased contraceptive uptake, in particular the use of long-acting methods, but did not reduce repeat abortion rates over the following 2 years [6]. A recent trial from the CHOICE project in the United States showed a reduction in population-based repeat abortion rates with directed counseling, provision of free product and immediate access to contraceptive methods amongst a cohort of women who opted to enroll in the trial [7].…”

The diet of Atlantic Yellow-legged Gulls (Larus michahellis atlantis) at an oceanic seabird colony: estimating predatory impact upon breeding petrels

“…Abortion counselling is consistently described as useful. Its benefits include (1) more positive and respectful client-provider interactions resulting in higher client satisfaction; (2) less negative feelings and pain related to lack of clinical information; (3) greater compliance to follow-up care and effective contraception (although some research 29 shows otherwise); (4) prevention and management of poor emotional post-abortion adjustment; (5) clients' increased participation in the protection and promotion of their own health by further seeking healthcare in the future 12,14,16,[26][27][28] .…”