Contraception 2014;89:42–7

Immediate versus delayed initiation of the contraceptive patch after abortion: a randomized trial

Jody E. Steinauer, Abby Sokoloff, Elizabeth M. Roberts, Eleanor A. Drey, Christine E. Dehlendorf and Sarah W. Prager

Abstract

Background: Immediate start of the contraceptive patch has not been studied in women after surgical abortion.

Study Design: Women presenting for surgical abortion who had chosen the transdermal patch for contraception were randomized to either delayed start of the patch (beginning the Sunday after their abortion) or immediate start (directly observed application of the patch in the clinic). Subjects were contacted at 2 and 6 months to assess contraceptive use.

Results: Two hundred ninety-eight women were randomized, and the follow-up rate was 71% at 2 months and 53% at 6 months. Method continuation did not differ by timing of initiation. At 2 months, 71% in the delayed-start group and 74% in the immediate-start group were using the patch [p = 0.6, with a difference of 3.1%, 95% confidence interval (CI) = -17.2% to +11.2%]. At 6 months, 55% in the delayed-start group and 43% in the immediate-start group were using the patch (p = 0.13, with a difference of 11.9%, 95% CI = -19.2% to +34%).

Conclusion: Immediate initiation of the contraceptive patch after surgical abortion was not associated with increased use of patch at 2 or 6 months.

Comment: As with contraceptive pills, implant or contraceptive vaginal ring, the contraceptive patch can also be used immediately after abortion. This is important, because women usually want reliable contraception soon after their abortion and many women do not come back for a 6-week follow-up visit. (Hans Vemer)