Barriers associated with the failure to return for intrauterine device insertion following first-trimester abortion

Contraception. 2009 Mar;79(3):216-20. doi: 10.1016/j.contraception.2008.09.003. Epub 2008 Oct 22.


Background: The aim of the study was to identify barriers associated with the failure to return for delayed intrauterine device (IUD) insertion postabortion.

Study design: This study had two components: (a) a retrospective cohort study of women who chose an IUD as their postabortion contraceptive method to compare characteristics of those who did and did not receive a device within 6 months of the procedure and (b) a prospective survey of women intending IUD use postabortion to assess actual IUD use at 6 weeks, barriers to access and attitudes on insertion timing.

Results: Of the 500 abortion patient charts available for review during the study period, 53 women intended IUD use postabortion. At 6 months, only 32% intending an IUD received one, and there were no significant demographic differences between the groups. For the prospective portion, the response rate at 6 weeks was 54% (27/50), with only 26% (7/27) of responders reporting IUD insertion by this time. The principal reported barrier to IUD insertion was time needed for an additional visit (41%). Most women (67%) desired immediate insertion and believed that they would be more likely to have an IUD inserted if it is performed immediately postabortion (63%). Monthly income was the only statistically significant difference between those who responded to the 6-week follow-up (US$1409.50) and those who did not (US$937.50, p=.05).

Conclusion: A significant number of women that express a preference for IUD use after first-trimester abortion do not return to obtain a device. Most would prefer to have the option of immediate insertion.

Publication types

  • Comparative Study

MeSH terms

  • Abortion, Induced
  • Adult
  • Female
  • Humans
  • Intrauterine Devices / statistics & numerical data*
  • Patient Compliance / statistics & numerical data*
  • Patient Satisfaction
  • Pregnancy
  • Pregnancy Trimester, First
  • Prospective Studies
  • Retrospective Studies
  • Time Factors
  • Young Adult