Factors Affecting the Contraceptive Choices of Women Seeking Abortion in a Nonurban Area

OBJECTIVE: To characterize contraceptive use and preferences among women in Iowa seeking abortion. STUDY DESIGN: Cross-sectional study conducted between 6/2012 and 11/2012 at 4 Iowa reproductive health clinics. All women seeking abortion were offered an anonymous written survey inquiring about contraceptive use, preferences, and perspectives. RESULTS: Of 408 women completing surveys, 218 (53.4%; 95% CI 48.5-58.4%) were not using contraception at the time of conception, which is higher than the national average (46%). Of those using contraception, combined hormonal pills were the most common method (49.0%). The most common reasons for nonuse included side effects (29.0%) and belief in low risk of unintended conception (26.2%). Postprocedure, 91.2% of respondents were discharged with a contraception plan, most often with oral contraceptives (41.9%). Ease of use was cited as the most important reason for the chosen method. Women cited concerns about side effects such as weight gain (67.9%) and irregular bleeding (32.9%); however, the rates of these concerns were not different between contraception users and nonusers (p = 0.70 and p = 0.27, respectively). CONCLUSION: Contraception nonuse prior to abortion in nonurban populations is higher than the national average. Adequate and accurate counseling of women about contraceptive options and risk of unintended pregnancy is vital to empower effective and sustained contraceptive use post-abortion.