Elective pregnancy termination at women’s request is still stigmatized, especially if it is a repeat abortion. This study’s objectives were to determine the incidence of repeat abortion, consider the contraceptive method chosen after the index abortion event, and characterize the risk factors for repeat abortion.

This was a retrospective cohort study of 988 women who requested pregnancy termination during 2015 in a Portuguese tertiary care public hospital. 

Forty-nine of the 988 women had a repeat abortion. Users of LARC had fewer repeat abortions compared with users of non-LARC methods. Overall, repeat abortion was 0.8% in subcutaneous contraceptive implant users, 1.5% in IUCD users, 2.8% in vaginal ring users, and 5.8% in oral contraceptives. Cox HR analysis showed that method choice after abortion correlated significantly with the probability of repeat abortion. Using women choosing oral contraception as the reference group, the HRs for repeat abortion were as follows: IUCD 0.282, contraceptive implant 0.142, vaginal ring 0.508.

Even though highly effective contraceptive methods are freely accessible in Portugal, other challenges must be managed to improve outcomes, such as a timely, patient-centered counseling approach.

Reference: https://www.tandfonline.com/doi/full/10.1080/13625187.2020.1764527