D. Kirkham


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    Long-acting reversible contraception (LARC)
    take-up following termination of pregnancy.
    A local audit
    Kirkham, D1; Holt, E2; Agass, R3; Holland, C4;
    Dodsworth, B4
    1 Stockport NHS Foundation Trust, UK; 2 Royal Bolton NHS
    Foundation Trust, UK; 3 Pennine Acute Hospital NHS Trust, UK;4 Salford Royal NHS Foundation Trust, UK
    Objectives: Identify the percentage of women undergoing a
    termination discharged with LARC, and factors influencing take-
    Methods: Age, contraceptive history, parity, previous termination,
    and discharge contraception were recorded for women attending a
    termination clinic over two months. Ninety-nine cases were
    Discharge contraception was discussed with 100% of cases;
    92.9% made a contraception decision, 79.8% were discharged with
    a chosen method, 13.1% were guided to a family planning centre,
    7.8% declined contraception (condoms supplied), 59.6% were
    discharged with LARC.
    Relevance/Impact: Less than 10% of unintended pregnancies are
    due to true contraception failure, 30–50% because no method was
    used, the remainder due to incorrect/inconsistent use. In
    unintended pregnancies 40.6% lead to termination of pregnancy
    (TOP); 27–48% of all TOP are repeats. Women seeking TOP are
    highly motivated to seek effective contraception. LARC methods

    are not user-dependent, so are very effective. LARC is more cost-
    effective than the combined oral contraceptive pill (COCP) after
    just 1 year. A reduction in unwanted pregnancies and
    terminations benefits the physical/mental health of women and
    the NHS financially.
    Outcomes specific patient groups may benefit from targeted
    counselling to increase uptake of LARC: (i) Patients conceiving
    on the COCP (ii) 14–17 year olds (iii) Nulliparous women
    (iv) Patients with previous terminations.
    Discussion: Sixty-five percent of patients using no contraception
    or condoms, and 75% of women aged 18–22 years old were
    discharged with LARC. Only 32% of patients conceiving on the
    COCP were discharged with LARC, and only 40% of 14–17 year
    olds, with 53% being discharged on the COCP and one with
    condoms. Forty-two percent of nulliparous women were
    discharged with LARC. Patients with previous terminations were
    no more likely to be discharged with LARC.