Contraceptive use among immigrant and non-immigrant women seeking abortion care in Stockholm County
Karin Emtell Iwarsson1, Elin Larsson1, Kristina Gemzell-Danielsson1, Birgitta Essen2, Marie Klingberg-Allvin1
1Karolinska Institutet, Stockholm, Sweden, 2Uppsala University, Uppsala, Sweden
Background: Globally, immigrant women encounter more challenges in reproductive healthcare than non-immigrants. A previous Swedish study showed being foreign-born was a risk factor for induced abortion and immigrant women had less experience of contraceptive use compared to non-immigrants. In order to ensure equitable care, it is important to investigate if this pattern still exists.
Aim: To compare the contraceptive use ever in life, at conception and planned use after an induced abortion, including type of methods, between immigrant and non-immigrant women seeking abortion care in Stockholm County.
Method: A cross-sectional study using an interview-based questionnaire, conducted at six abortion clinics. In total 637 women responded.
Results: In the study 425 were non-immigrants and 212 immigrants. A significant difference was observed within the immigrant group, therefore it was divided into foreign-born (148) and 2nd generation migrants (64). For all women, 96% reported they had used contraception ever in life. A significant difference was seen where non-immigrants had used pills and withdrawal to a higher extent, and foreign-born women had used copper IUD. At time of conception, 34% had used contraception. There was no significance between the different methods. Planned future use of contraception was 93%. Copper IUD was significantly more common among foreign-born women, implant among 2nd generation migrants and vaginal ring among non-immigrants. 52% of all women planned to use long acting reversible contraception (LARC = IUD’s and implants) after the abortion.
Conclusion: Immigrant women seem to have less experience of contraceptive use ever in life, at conception and as planned future method compare to non-immigrants. A significance was seen between non-immigrants, foreign-born women and 2nd generation migrants for different types of contraceptive methods ever in life and as planned future method. Efforts are needed to improve access to contraceptives among immigrants and to increase the use of LARC among all groups.