Myths and misconceptions about intrauterine contraception abound, a study in women seeking termination of pregnancy has shown.

This study took place at the Royal Infirmary of Edinburgh which provides up to 80% of abortion services in Lothian, Scotland. Women undergoing abortion were recruited to complete a short questionnaire regarding their beliefs about intrauterine contraception.

A total of 106 questionnaires were completed out of 125 distributed, a response rate of 85%. Age of respondents ranged from 15 to 42 years. Overall 83 women (78%) had used more than one method of contraception before, and 8% had used an intrauterine method.

Two women were uncertain about future contraception after abortion and three were not intending to use any. Of the remaining 101 women, 31% intended to use the oral contraceptive pill, 25% intrauterine methods, 24% a progestogen-only implant; 24% barrier methods, 12% a progestogen-only injectable, 3% a combined hormonal contraceptive patch and 2% sterilisation.

Parous women were significantly more likely to use intrauterine contraception than nulliparous women as were women who had had an abortion previously.

Statements about intrauterine contraception were extracted from two sources: unpublished transcripts of interviews undertaken with young people as part of a national teenage pregnancy strategy evaluation;

and an online social networking and microblogging service. The agreement rate to negative statements regarding intrauterine contraception varied from 3 to 34%, see table 1.

Despite the range of responses, it was reassuring that the majority of women did not agree with the statements. However, between 26% and 56% of the women neither agreed nor disagreed; the authors suggested this could reflect lack of knowledge about this method of contraception.

In 2011, 29% of women who had an abortion in Scotland and 35% in England and Wales had had at least one previous abortion. The NICE guidance on Long Acting Reversible Contraception (LARC) suggests use of intrauterine contraception at the time of abortion significantly reduces the likelihood of subsequent abortion.

Increased uptake of LARC especially intrauterine contraception could reduce unplanned pregnancies and abortion.

Consultation regarding abortion referral may provide a good opportunity to discuss future contraception. However, some healthcare professionals may cite time pressures and a perception by women that they might feel under pressure to accept contraception before an abortion referral could proceed.

Published evidence suggests women value the opportunity to discuss contraception and do not feel coerced into accepting a method before referral. Studies from the USA suggest that even a three-minute discussion about intrauterine methods can improve knowledge and attitudes to their use.

Although this study focused on women having an abortion, it may be useful for clinicians to include the common myths and misconceptions in contraception discussions with women to reduce anxieties and improve acceptance of LARC.

Dr Richard Ma