Condom failures in women presenting for abortion

To document the main reasons for condom failure in women presenting for first trimester termination of pregnancy.

From 1990-97 an audit was carried out, on the 3283 cases personally operated on by the author, using the information routinely obtained during pre-operative counselling.

Two sets of figures were obtained. The first (minimum figures) were restricted to those who used condoms on every occasion of coitus (746 or 22.7% of all women seen). The second (maximum figures) included all of these plus those who did not use condoms on every occasion or who used condoms in conjunction with another method (1494 or 45.5% of all women seen). In this expanded group, there was no obvious cause for the failure in 446 (29.9% of condom users). The main reason for failure was not using condoms every time (736 or 49.3% of condom failures). Leakage of semen occurred in 321 cases (21.5% of condom failures) and 104 of these had used emergency contraception which had also failed (7.0% of condom failures). Condoms failed more often in women under 25 years of age.

There is a need for better education on correct condom use and improved availability of emergency contraception. There is also a need for greater standardisation in reporting contraceptive failure.