"I thought i was protected" Abortion, contraceptive uptake and use among young women: a quantitative survey

In 2012, when this research study began, the total number of abortions in England and Wales was 185,122. This was 2.5% fewer than in 2011 (189,931) [1]. The latest government abortion statistics show that there was a total of 185,331 abortions in 2013 which is 0.1% more than in 2012 [1]. The percentage of women undergoing an abortion who have had one or more previous abortions is increasing, with more than one in three abortions in the UK (37%) being a subsequent episode, an increase from 34% in 2010 and 31% in 2002. Among women under 25 years, 27% had a previous abortion in 2012, a slight increase since the previous year (26%). This proportion was also the same for under-25 year old women in 2013. This increase may indicate a gap between provision of abortion care and effective post abortion contraception use among this population. Reasons for unintended pregnancy are well documented, and include non-use of contraception, failure of a contraceptive method, poor knowledge of methods, cultural or religious barriers, fear or misconceptions of side effects, and relationship changes [2-6]. Factors associated with why some women who have an abortion go on to have a subsequent abortion are less evidence based. It has been acknowledged that increasing access to contraceptive information and services is too simplistic a solution [7]. There are no known UK studies that provide quantitative data about post abortion contraceptive practices among young women. While post-abortion contraceptive services for young women have become a government policy priority, more needs to be understood about why some young women struggle to exercise reproductive control, and do not use contraception effectively; as well as about service provider and other factors that may influence its initiation and continuation. Marie Stopes International (MSI) is one of the UK’s leading reproductive health agencies and is the largest provider of abortion services. Given the lack of understanding regarding the complex interplay of factors that influence the incidence of successive episodes of abortion, MSI commissioned a mixed method study to investigate different aspects of young women's experiences of one or more unintended pregnancy ending in abortion. This paper reports on the second component of the study: a quantitative survey. It draws on the survey results to identify ways in which local sexual health strategies and services can support young women after abortion, helping them to improve their reproductive control and avoid further unintended pregnancies.