Sally B Rose, Susan M Garrett

To determine whether there is regional variation in the immediate postabortion initiation of long-acting reversible contraception (LARC) in New Zealand. Retrospective analysis of nationally collected data on receipt of intrauterine and implantable contraception at the time of an abortion, together with demographic characteristics and region of residence for the year 2013. Postabortion LARC initiation varied significantly between the 16 regions of New Zealand, ranging from 32% (95% CI 23.2-42) to 61.4% (95% CI 53.3-69). Implant use ranged from 6.8% to 32.7% across regions, and intrauterine method use ranged from 21.4% to 54.7%. Regional variation in total LARC uptake was most marked for under 20-year-olds (20.3% to 70.9%). The ratio of intrauterine to implant users ranged from 0.7 to 4.1 across regions, with intrauterine methods prescribed two and a half times more frequently nationwide. These regional differences in postabortion LARC initiation suggest there are between-clinic differences in prescribing. Reasons for these differences need to be examined to identify and address any barriers faced by clinics in the routine provision of postabortion LARC. Equitable access to LARC at the time of an abortion is needed throughout New Zealand to assist women in the prevention of future unintended pregnancies.