Background Repeat termination of pregnancy highlights the issues of unplanned pregnancies and effective post-termination contraceptive practices.

Objective To examine the risk factors at the time of a first termination that are associated with subsequent repeat termination.

Design Registry-based study.

Setting Grampian region of Scotland, UK.

Methods A retrospective study using data from the Termination of Pregnancy Database, NHS Grampian for the period 1997–2013. Associations between repeat termination and women's sociodemographic characteristics and contraceptive use were assessed using multivariable logistic regression models.

Results This study showed that 23.4% of women who had an initial termination (n=13 621) underwent a repeat termination. Women who had repeat terminations were more likely to be aged under 20 years at their initial termination with an adjusted odds ratio (AOR) of 5.59 [95% confidence interval (CI) 4.17–7.49], to belong to the most deprived social quintile [AOR 1.23 (95% CI 1.05–1.43)], and to be more likely to have had two or more previous livebirths [AOR 1.51 (95% CI 1.12–2.02)] or miscarriages [AOR 1.40 (95% CI 1.02–1.92)]. The likelihood of having a repeat termination was increased in women who had a contraceptive implant as post-termination contraception [AOR 1.78 (95% CI 1.50–2.11)] compared to women who left with none or unknown methods following the first termination. In those who had repeat terminations, women who had an implant or Depo-Provera^® were at increased odds of repeat termination in the 2–5 years interval compared to the 0–2 years after their initial termination.

Conclusions Teenage pregnancy, social deprivation, two or more previous livebirths or miscarriages at the time of the initial termination were identified as risk factors for repeat terminations. Post-termination contraception with implants and Depo-Provera® were associated with repeat termination 2–5 years after the first termination.