Audit of contraception provision following Termination of Pregnancy

Authors: Dr Lucy Michie – ST5, Dr Catriona Melville – Consultant SRH

Location: Ayrshire Maternity Unit, Kilmarnock

Background and Aim

The 2008 Quality Improvement Scotland Standards (QIS) for Sexual Health Services recommend that “60% of women leave the Termination of Pregnancy (TOP) facility with one of the more effective methods of contraception (hormonal oral contraceptives, intrauterine devices or contraceptive implants)”.The aim of our audit was to determine if contraception provision following Termination of Pregnancy (TOP) in Ayrshire and Arran met this QIS standard. An additional objective was to determine the proportion of women leaving the facility with a Long Acting Reversible Method (LARC) of contraception.

Methods

A retrospective case note audit of all women undergoing a termination of pregnancy in Ayrshire and Arran over a 3 month period from June - August 2010 was performed. Cases were identified over this time period and the electronic case record (Eclipse) was then searched for contraceptive choice and provision.

Results

212 case records were identified and reviewed. The mean age of patient was 23 years (range 13 - 49 yrs). The methods of contraception provided on discharge from the Day Ward are summarised in Table 1.

Table 1: Method of contraception on leaving the Day Ward

Number
Method given / (n=212) / % of total
Implanon / 54 / 25.5%
IUS / 25 / 11.8%
IUCD / 6 / 2.8%
COC / 54 / 25.5%
POP / 13 / 6.1%
Depoprovera / 19 / 8.9%
Condoms / 3 / 1.4%
Other / 38 / 17.9%

Conclusion

80.6% of women left the facility with one of the more effective methods of contraception (as defined by QIS).This rate exceeds the QIS standard of 60%. Additionally LARC methods accounted for 49.1% of all methods provided.

Lucy Michie

ST5 Obstetrics and Gynaecology
Ayrshire Maternity Unit