Termination of pregnancy: Lessons for prevention

An audit of the contraceptive practices of 733 of 759 women (96.6 per cent) undergoing NHS termination of pregnancy in Oxford between September 1988 and March 1989 was undertaken in order to develop a strategy for prevention of unwanted pregnancy. Three hundred and thirty four women (45.6 per cent) reported the use of a condom as their normal method of contraception, of whom 176 (24.0 per cent of all women) reported always using a condom during intercourse. These proportions are higher than in previous surveys of contraceptive use amongst women seeking termination. One hundred and eighty seven women (25.5 per cent) had stopped using oral contraception during the previous year. The most frequent reason given for choosing to use a condom was anxiety over the health risks of oral contraceptives and IUDs. Avoidance of AIDS was mentioned only by one respondent. Five hundred and fourteen pregnancies (70.1 per cent) were potentially, predictable by virtue of non-use of contraception or by recognition of method failure, but only 18 women (2.5 per cent) had used postcoital contraception, and of 104 women with a recognised failure of oral contraceptive use, 84 (80.2 per cent) were unaware of the need for a supplementary barrier method. The primary task in the prevention of a further rise in the termination rate is to increase recognition of the risk of pregnancy and to promote knowledge and accessibility of postcoital methods, particularly in the less than obsessional condom user and in the non-user of any method.