Intra-abortion contraception with etonogestrel subdermal implant

Objectives: Etonogestrel subdermal implant is a highly effective, reversible and safe form of contraception. Immediate placement during abortion visit could increase contraception use in women at high risk for unintended pregnancy. Our purpose was to evaluate patient acceptability, user continuation rate and efficacy of medical termination of pregnancy when the implant is inserted during medical termination of pregnancy.

Study design: Prospective observational study comparing patients who chose the subdermal implant for post-abortion contraception, inserted at the time of administration of mifepristone, with patients who chose delayed placement after the termination was complete.

Results: After contraceptive counseling 119 women chose the implant as their post-abortion contraceptive method. In the intra-abortion implant insertion group the user continuation rate after 6 months was 73.7% (42/57). In the delayed placement group 59.7% (37/62) missed the follow-up after abortion visit, 24.2% (15/62) chose another method and only 16.1% (10/62) had the implant inserted. The efficacy of medical termination was 96.5% in the group of intra-abortion implant insertion and 98.4% in the delayed placement group.

Conclusions: Intra-abortion subdermal implant insertion significantly increases the likelihood of effective long-acting contraception use following abortion. The efficacy of medical termination was not significantly changed by intra-abortion implant insertion.