Use of contraception in women who present for termination of pregnancy in inner London

Abstract Objectives : To describe the contraceptive usage of women undergoing termination of pregnancy in order to identify problems with contraception, and therefore suggest ways in which contraceptive services can be improved. Design : Prospective study of attenders for NHS termination of pregnancy over a three month period. Setting : Community based assessment clinics for NHS termination of pregnancy in inner London. Subjects : Two hundred and sixty-nine women asking for assessment for NHS termination of pregnancy. Main Outcome Measures : Source of contraception, method used around time of conception, and problems experienced. Results : Respondents fell into three groups: those using contraception around the time they became pregnant; those who had ceased to use contraception; and those that had never used contraception. The method of contraception used by the majority of the first group was the condom and the main source of the method was the chemist shop. The second group had most commonly used oral contraceptives in the past and had ceased use in many cases as a result of side effects. The majority of the third group did not speak English and had limited knowledge of methods of contraception. Conclusions : High usage of chemists means women avoid service providers who could offer help and advice. Women were prepared to put themselves at risk of unwanted pregnancy rather than return for further help and the lack of knowledge about emergency birth control was of some concern. The needs of black and ethnic minority women requires detailed work to improve access and acceptability of contraceptive services.