Purpose
To
describe changes in receipt of immediate postabortion long-acting reversible
contraception (LARC) by adolescent and nulliparous women in New Zealand.
Methods
Nationally
collected data on immediate postabortion receipt of an intrauterine method
(intrauterine device [IUD]/intrauterine system [IUS]) or contraceptive implant
were analyzed to describe proportions and demographic characteristics of women
receiving LARC between 2007 and 2013. Changes in uptake over time were
presented for adolescent, nulliparous, and parous women.
Results
Postabortion
LARC uptake increased between 2007 and 2013, rising from 7.9% to 42.7% for
adolescents and from 8.8% to 36.9% for nulliparous women. The increase was
highest among nulliparous adolescents with a seven-fold increase in LARC uptake
between 2007 and 2013. Adolescents had a five-fold increase and nulliparous
women (of all ages) a four-fold increase. In 2013, IUD/IUS use was lowest among
adolescents (22.4%) and increased with increasing age (43% by ages 40+ years),
whereas implant use was highest among adolescents (20.3%) and decreased with
increasing age (to 4.6% by age 40+ years). Nulliparous women had the lowest use
of both IUD/IUS and implants in 2013, with 24.6% receiving an intrauterine
method (compared with 43.2% for para 3+), and 12.3% an implant (compared
with 17.5% for para 3+).
Conclusions
Despite
an overall trend toward increased uptake of postabortion LARC by adolescent and
nulliparous women, uptake in these groups still lags behind that of parous and
older women. Reasons for differential uptake need to be explored and addressed
if necessary to ensure all women have equitable access to the most effective
methods of contraception.
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By:
Department of
Primary Health Care and General Practice, University of Otago, Wellington,
Wellington South, New Zealand
Correspondence
Address correspondence to: Sally B. Rose, Ph.D., Department
of Primary Health Care and General Practice, University of Otago, Wellington,
PO Box 7343, Wellington South 6242, New Zealand.
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