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Cohort study
Initiation of long-acting reversible contraceptive methods (IUDs and implant) at pregnancy termination reduces repeat abortion
  1. Colleen McNicholas,
  2. Jeffrey F Peipert
  1. Department of OB/GYN, Washington University in St Louis School of Medicine, St Louis, Missouri, USA
  1. Correspondence to: Jeffrey F Peipert
    Department of OB/GYN, Washington University in St Louis School of Medicine, Campus Box 8219, 4533 Clayton Avenue, St Louis, MO 63110, USA; peipertj{at}

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Despite the availability of effective modern contraceptive methods, unplanned pregnancy continues to be a major problem worldwide. In 2008, the worldwide abortion rate was found to be 28/1000 women aged 15–44, unchanged from 2003 rates of 29/1000 women.1 Immediate initiation of long-acting reversible contraceptive (LARC) methods following pregnancy termination has been identified as an effective strategy to reduce repeat unintended pregnancy and abortion. Access to these LARC methods—intrauterine devices (IUDs) and implants—continues to be problematic, especially in the setting of pregnancy termination. Previous research has shown that delayed initiation of these methods often results in failure to obtain the method. Improving access to the most effective methods at the time of termination when women are particularly motivated …

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  • Competing interests None.