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

This was a pilot trial with a small sample size and no formal sample size calculation, so it cannot provide definitive evidence. Randomization did not balance baseline intention to use LARC: more women who intended to use LARC were allocated to the intervention arm, and a post-hoc analysis of women who did not intend LARC was not statistically significant. The study was conducted in one urban academic clinic, and usual care was delivered by physicians, family planning fellows, or faculty who may be highly invested in contraception uptake. The intervention was delivered by trained professionals, a physician and a licensed clinical social worker, not by nurses or lay counselors, and one counselor left during recruitment, after which the remaining counselor performed all later sessions. The principal investigator helped design the study, counsel participants, and analyze outcomes, which introduces risk of bias. No periodic re-training, MI fidelity evaluation, or individual session quality monitoring was performed. Follow-up was short and did not allow meaningful assessment of repeat pregnancy. At three months, 51 women were contacted, and retention was 85%, so not all participants were followed.

Do not conclude that motivational interviewing counseling alone causes higher long-acting contraceptive uptake or that nurses can implement it unchanged. The intervention arm also received usual non-standardized contraception counseling, the study was a small pilot with randomization imbalance, and counseling was delivered by trained professionals, one of whom was the study investigator.