The effect of consolidation of abortion services on patient outcomes

Background: In 2001, a service dedicated to family planning was created within a large public hospital to improve patient care services. This retrospective chart review demonstrates the benefit of focusing these services in a specialty clinic. Study Design: A power analysis was performed and determined that a minimum of 136 charts were needed in each arm of the study to determine if, following an elective abortion, there was a significant increase in attendance at the scheduled postoperative visit. Secondary variables included analysis of contraceptive choice, incidence of continuation of injectable contraception and incidence of repeat pregnancy. Results: After counseling services were initiated, there was a 27% increase in the number of patients returning for the postoperative clinic appointment within 8 weeks [32% (61/191) in 1998 vs. 59% (80/136) in 2001; p<.0001]. There was also a significant decrease in patients without a plan for contraception, 29% in 1998 vs. 11% in 2001, and a decrease in repeat pregnancies from 9% in 1998 to 1.5% in 2001. There was no difference in patient adherence with injectable contraception. Conclusion: Consolidation of abortion services improves subsequent use of contraception and reduces incidence of repeat pregnancy.