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Intrauterine devices reduce repeat abortions

A study from the University of Gothenburg, Sweden, which monitored a group of women for 25 years showed that the combined oral contraceptive pill (the pill) is the most common form of contraceptive among women under 29. At the same time many young women have unwanted pregnancies resulting in repeated abortions. According to the researchers increased use of an intrauterine device at a younger age would reduce the number of unwanted pregnancies.

Ingela Lindh is a midwife and researcher at the Department of Obstetrics and Gynecology at Sahlgrenska Academy. She is part of a study group who monitored 286 women for 25 years of their fertile period, between 19 and 44 years of age. "We found that 98 per cent of women had at one time or another used some form of contraceptive and that 95 per cent of women had used the pill. The pill is the most common method among women up to the age of 29, among older women the medicated intrauterine device (Mirena®) and copper intrauterine devices are more common", says Ingela Lindh.

The researchers then compared the type of contraceptive used by the women with the number of pregnancies during the same period. This resulted in a clear connection between the type of contraception and the number of pregnancies.

"When we compared women who had not been pregnant at the age of 19 with women who had been pregnant at that age, the study showed that these women had significantly more pregnancies up to the age of 24. This increase subsided rapidly as the women became older which was probably due to the increased use of an intrauterine device in this group of women", says Ingela Lindh.

Therefore, she is of the opinion that health care providers should take measures to increase the use of long acting contraceptive methods such as intrauterine devices, which to a significant extent reduced repeat abortions as it is a more effective and permanent contraceptive than the pill.

"We need more active management from health care providers for women who have undergone one or more abortions. It would be advantageous to have a quicker return visit after an abortion where you can discuss the pros and cons of different contraceptives and highlight the use of long acting methods such as an intrauterine device as a good alternative to the pill", says Ingela Lindh.

The current abortion law in Sweden was introduced in 1975. Since then, the number of abortions per year has varied between approximately 32,000 and approximately 38,000. Sweden has one of the highest abortion rates in Western Europe and the number of repeated abortions in Sweden amounts to around 38 per cent. Abortions are most common among women between the ages of 20-24.
For more information please contact:
Ingela Lindh, midwife and doctoral postgraduate at the Department of Obstetrics and Gynecology, the Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg. Telephone +46 76-136 17 60.

Journal: Human reproduction, 14 April 2010.
Title of the article: A longitudinal study of contraception and pregnancies in the same women followed for a quarter of a century.

Authors: Ingela Lindh, Agneta Andersson Ellström, Febe Blohm and Ian Milsom

Helena Aaberg | idw
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