Kate Guthrie


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    The impact of implants and intrauterine
    contraceptives provided at an index surgical
    termination of pregnancy (Jan–June 2008) on
    repeat termination of pregnancy within 3 years:
    an audit
    Latham, F1; Guthrie, K2; Trussell, J1
    1 Hull York Medical School; 2 Community Health Care Partnership
    Hull, UK
    Background: Implants and intrauterine contraceptives have lower
    failure rates and higher continuation rates than the other
    reversible methods of contraception. We hypothesised that the
    patients who chose these long lasting reversible methods after
    their index surgical termination of pregnancy (STOP) would have
    a reduced incidence of subsequent termination of pregnancy
    (TOP) in comparison to those who chose other reversible
    methods (injections, oral contraceptive pills, patch, ring and
    Methods: Index cases were recorded retrospectively from theatre
    registers at Hull Royal Infirmary for all STOPs between January
    and June 2008. Type of contraception chosen at procedure was
    recorded: Implanon, Mirena, IUD, Depo-Provera, Sterilisation and
    ‘Other’ (oral contraceptives, patches, rings, condoms). The
    hospital information system for the subsequent 3 years was
    searched for another TOP (surgical or medical). The data were
    analysed. A secondary objective was to record contraceptive
    choices in two age groups (<25 and ‡25 at index STOP).
    Results: Women choosing Implanon, Mirena and IUDs had a
    significantly lower repeat TOP rate than those choosing other
    reversible methods at 2 (3.4% vs. 9.3%, P = 0.008) and 3 (6.8%
    vs. 12.4%, P = 0.04) years. As age increased, use after an index
    STOP of Implanon decreased (32% vs. 8%) and Mirena increased
    (13% vs. 41%) significantly.
    Conclusion: A 50% increase in the uptake of implants and
    intrauterine contraceptives would decrease the repeat TOP rate
    within three years by 16%.

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    UK Faculty programme

    Katherine Guthrie City Health Care Partnership CIC, Hull, UK - k.guthrie@nhs.net

    Training in abortion provision is within the postgraduate specialty training programmes of the Faculty of Sexual and Reproductive Healthcare (FSRH) and the Royal College of Obstetricians and Gynaecologists (RCOG). These cover medical abortion and 1st trimester surgical abortion. The RCOG programme does not cover local anaesthetic procedures. The College has an optional advanced programme to cover local anaesthetic procedures and later gestations for surgery. The Faculty also has a training programme accessible to doctors and nurses who wish to undertake further training in this field. Conscientious objection within the National Health Service plus the shift in the provision of care to non-NHS providers has created a challenge in accessing training.