Our objective was to examine the impact of prior healthcare provider counseling on previous use of contraception and knowledge of emergency contraception in women seeking surgical abortion. We performed a retrospective analysis of 342 patient charts from women seeking an office abortion in a private practice setting from January 1999 to June 2001. Data extracted included demographic information, primary method of contraception over the preceding few months, compliance with that method, contraceptive history, knowledge of emergency contraception and postabortion contraception. Patients were primarily white (69%) and unmarried (63%) and had private insurance that covered abortion services (72%). Only 19% of women were using a birth control method with no recognized potential failure. Twenty-two percent of women were using their birth control method correctly but experienced an event that put them at risk for pregnancy, 32% were using their birth control method incorrectly and 27% were using no birth control method at all. Miscommunication between patients and their healthcare provider(s) negatively affected use of a primary contraceptive method in 14% of patients. Of the 77% of women who did not know about emergency contraception, nearly two thirds had an identifiable event for which emergency contraception could have been used. Healthcare providers may contribute to the occurrence of unintended pregnancy if they provide poor medical advice or miscommunicate with patients.