The effect of a patient-centered contraceptive counseling in women who undergo a voluntary termination of pregnancy

Objective: The aim of the study was to evaluate, by means of a randomized controlled trial, whether a patient-centered contraceptive counseling intervention increased the use of contraception, and the knowledge and positive attitudes towards contraception, in women who undergo a termination of pregnancy (TOP). Methods: The study was carried out at the San Paolo Hospital of Milan between the 1st of February and the 31st of May 2004. Participants (41 women; ages 20-44 years) were randomly divided into two groups: an experimental group (n = 20), who received patient-centered contraceptive counseling, and a control group (n = 2 1), who received the routine treatment in use at the San Paolo Hospital and were referred to the community health centers after the TOP. Both groups were administered a questionnaire at two points in time (before the counseling and 1 month later) which evaluated participants' knowledge, attitudes and use of contraception (the latter was also followed up 3 months later). The counseling intervention lasted 30 min and was carried out by a psychologist and a gynaecologist. Results: It was found that knowledge, favorable attitudes and use of effective contraception increased significantly for the experimental Group, whereas there was no significant change for the control group. Conclusion: The counseling intervention was therefore found to be efficacious in improving understanding and use of contraception in women who have undergone a TOP. The hope is that this will contribute to increased use of effective contraception in the future. Practice implications: Following the principles of patient-centered medicine, this study provides evidence for the importance of exploring woman's feelings, beliefs, wishes and expectations regarding contraception within a contraceptive counseling intervention.