A motivational interviewing-based counseling intervention to increase postabortion uptake of contraception: A pilot randomized controlled trial

• Motivational interviewing may be a suitable approach for contraception counseling.
• MI-based counseling led to higher uptake of long-acting reversible contraception.
• MI-based counseling led to more use of LARC three months after abortion.
• Women were more satisfied with MI-based vs. non-standardized counseling.

ObjectiveTo determine if a counseling intervention using the principles of motivational interviewing (MI) would impact uptake of long-acting reversible contraception (LARC) after abortion.MethodsWe conducted a pilot randomized controlled trial comparing an MI-based contraception counseling intervention to only non-standardized counseling. Sixty women 15–29 years-old were randomized. Primary outcome: uptake of LARC within four weeks of abortion. Secondary outcomes: uptake of any effective contraceptive, contraceptive use three months after abortion and satisfaction with counseling. Bivariate analysis was used to compare outcomes.ResultsIn the intervention arm, 65.5% of participants received a long-acting method within four weeks compared to 32.3% in the control arm (p = 0.01). Three months after the abortion, differences in LARC use endured (60.0% vs. 30.8%, p = 0.05). Uptake and use of any effective method were not statistically different. More women in the intervention arm reported satisfaction with their counseling than women in the control arm (92.0% vs. 65.4%, p = 0.04).ConclusionTwice as many women in the MI-based contraception counseling intervention initiated and continued to use LARC compared to women who received only non-standardized counseling.Practice implicationsA contraception counseling session using the principles and skills of motivational interviewing has the potential to impact LARC use after abortion.