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Abortion Recidivism

A Problem in Preventive Medicine

From the Mount Sinai School of Medicine, The Mount Sinai Hospital, and the City Hospital Center at Elmhurst, NY.

Abstract

Despite intensive family planning counseling, repeat abortion patients began to appear at a rate of 5% within the first 12 months of a new pregnancy termination program at City Hospital Center. The reasons for contraceptive failure and abortion recidivism were categorized as: a) patient failure (61.0%), b) method failure (24.4%) and c) institutional failure (14.6%). Never-married nulliparas formed a unique sub-set of repeat abortion patients, constituting about one-third of the group; 88.2% were less than 24 years of age and had a significantly greater deficit in motivation for contraception. To combat this unacceptably high rate of abortion recidivism, immediate postabortion IUD insertion was recommended as the preferred method of birth control. Abortion morbidity was not increased by this technic and spontaneous IUD expulsion rates and removals-for-cause were low. Patient acceptance of this program was gratifying (64.5%) and even higher (73.3%) in the young, poorly motivated, never-married nulliparas. The study interval was too brief to permit evaluation of the effect of this program on the rate of abortion recidivism at this institution, but the high rate of patient acceptance indicates that immediate postabortion IUD insertion seems to offer the best opportunity to reduce this public health problem.