1. Contraceptive use among migrant and non-migrant women seeking abortion care in Stockholm, Sweden MERH Conference Edinburgh, 19th May 2018 Elin C. Larsson Karolinska Institutet (KI) and Uppsala University (UU), Swe Co-authors: Karin Emtell Iwarsson, KI; Marie Klingberg-Allvin, KI, Kristina Gemzell-Danielsson, KI and Birgitta Essén, UU

2. - Reproductive health research among female migrants to Western countries
The majority related to
pregnancy
12 % - other
Gagnon et al., 2016

3. Background
Migrant women seek induced abortion to a higher extent than non-migrant women*
Migrant women have less experiences of contraceptive use as compared to non-migrants**
*Helström et al., 2003; Ostrach, 2013; Rademakers et al.,2005; Rasch et al., 2008; Sedgh et al., 2011; Vangen et al., ** Helström et al., 2003; Prey et al., 2014; Wiebe 2013

4. Aim To compare the use of, and type of contraceptive methods:
ever in life and,
planned use after an induced abortion
among migrant, non-migrant and 2nd generation migrant women, and compare background factors between the three groups
Karin Emtell Iwarsson

5. Method Cross-sectional multicenter study Interview-based questionnaire
Six abortion clinics (55% of all abortions in Stockholm)
Women 18 years and older
January-April 2015
Interpreter used when needed
Definitions
Migrant = women not born in Sweden
2nd generation migrants= born in Sweden, both parents born abroad

6. Resultat Total women 637 Majority population 425 (67%) Migrant women
148 (23%)
2ed generation migrant
64 (10%)

7. Results. Age distribution

8. Results. Age distribution

9. Results. Age distribution

10. Results. Previous pregnancies and previous abortions
Previous pregnancy
Non-migrant %
2nd generation %
Migrant %
Yes
67.5
71.9
82.6 No
32.2
28.1
17.4
Previous abortion
72.5
69.6
63.4
27.5
30.4
36.6
Number of previous abortions
One
58.7
50.0
61.5
Two
26.9
25.0
Three
9.6
6.3
7.7
Four or more
4.8
18.8
3.8

11. Results. Previous pregnancies and previous abortions
Previous pregnancy
Non-migrant %
2nd generation %
Migrant %
Yes
67.5
71.9
82.6 No
32.2
28.1
17.4
Previous abortion
72.5
69.6
63.4
27.5
30.4
36.6
Number of previous abortions
One
58.7
50.0
61.5
Two
26.9
25.0
Three
9.6
6.3
7.7
Four or more
4.8
18.8
3.8

12. Results. Previous pregnancies and previous abortions
Previous pregnancy
Non-migrant %
2nd generation %
Migrant %
Yes
67.5
71.9
82.6 No
32.2
28.1
17.4
Previous abortion
72.5
69.6
63.4
27.5
30.4
36.6
Number of previous abortions
One
58.7
50.0
61.5
Two
26.9
25.0
Three
9.6
6.3
7.7
Four or more
4.8
18.8
3.8

13. Results Contraceptive use ever in life
Method
Non-migrant
Migrant
2nd generation
Total
(p-value)
Any
99%
89%
95%
96%
Pills
63%
80%
83% (<0.001)
Copper-IUD
17%
24%
10%
18% (0.047)

14. Results. Planned future ues of contraceptive
Method
Non-migrant
Migrant
2nd generation
Total
(p-value)
Any
95%
90%
91%
93%
(0.051)
Hormon-IUD
28%
30%
31%
29%
(0.760)
Pills
23%
16%
26%
(0.083)
Copper-IUD
13%
22%
14%
15%
(0.033)
Implant 7%
11% 8%
(0.036)

15. Conclusion 2nd gen. migrant women (vs. migrant and non-migrant)
younger
higher frequency of previous abortions
Migrant women (vs. non-migrant/2ed gen. migrant)
older
lower use of contraceptives

16. Conclusion Migrant and 2nd generation migrant women
lower use of contraceptives ever in life, and planned use as compared to non-migrants
Differences were seen between non-migrant, migrant women and 2nd generation migrants for types of contraceptive methods used ever in life and planned future method
Karin Emtell Iwarsson

17. Thank you!