Journal of Pediatric and Adolescent Gynecology
Volume 20, Issue 2 , Pages 61-65, April 2007

Preventing Repeat Teen Pregnancy: Postpartum Depot Medroxyprogesterone Acetate, Oral Contraceptive Pills, or the Patch?

  • Andrea Ries Thurman, MD

      Affiliations

    • Department of Obstetrics and Gynecology, Medical University of South Carolina, Charleston, South Carolina
    • Corresponding Author InformationAddress correspondence to: Andrea Ries Thurman, MD, Obstetrics and Gynecology, University of Texas Health Sciences Center San Antonio, 7703 Floyd Curl Drive, Mail Code 7836, San Antonio, TX 78229-3900
    • ,
  • Natalie Hammond, MD

      Affiliations

    • Department of Obstetrics and Gynecology, Medical University of South Carolina, Charleston, South Carolina
    • ,
  • Helen E. Brown, MD

      Affiliations

    • Department of Obstetrics and Gynecology, Medical University of South Carolina, Charleston, South Carolina
    • ,
  • Mary Ellen Roddy, PhD

      Affiliations

    • Department of Epidemiology, University of South Florida, Tampa, Florida, USA

Abstract 

Study Objective

To prospectively evaluate the repeat teen pregnancy rates, within one year of delivery, among adolescents who choose the contraceptive patch (Ortho Evra) versus oral contraceptive pills (OCP) versus Depot Medroxyprogesterone Acetate (Depo Provera, DMPA) for postpartum contraception.

Design

Observational, prospective cohort study. Comparison groups are postpartum teens, who self-select the contraceptive patch (n = 55) versus DMPA (n = 142) versus OCPs (n = 55) immediately postpartum.

Setting

Medical University of South Carolina, a tertiary medical center.

Participants

Postpartum teens, 11–19 years old; 72% were African American, and 96% qualified for Medicaid insurance.

Interventions

A structured telephone interview was performed every 3 months.

Main Outcome Measures

The primary outcome measure was a repeat pregnancy within 12 months of the index delivery. Secondary outcome variables were contraceptive continuation rates, reasons for discontinuation, side effects and condom usage.

Results

At 1-year follow-up, repeat pregnancy rates were 14.2%, 29.7%, and 31.8% among DMPA, OCP, and patch users respectively (P = 0.02). DMPA users were significantly more likely to be using any form of hormonal contraception 1 year postpartum than patch or OCP users. Condom use was similarly low among all cohorts.

Conclusion

Adolescents who choose DMPA for postpartum contraception are significantly less likely to become pregnant within 1 year of delivery, as compared to teens who choose OCPs or the patch.

Key Words: Teen pregnancy, Postpartum contraception, Birth control patch

To access this article, please choose from the options below

Login to an existing account or Register a new account.

  • Purchase this article for 30.00 USD (You must login/register to purchase this article)

    Online access for 24 hours. The PDF version can be downloaded as your permanent record.

  • Subscribe to this title

    Get unlimited online access to this article and all other articles in this title 24/7 for one year.

  • Claim access now

    For current subscribers with Society Membership or Account Number.

  • Visit SciVerse ScienceDirect to see if you have access via your institution.
 

 The interim data were presented as an oral presentation at the North American Society for Pediatric and Gynecology Meeting, Orlando, FL, 19 May 06.

PII: S1083-3188(06)00339-1

doi:10.1016/j.jpag.2006.11.006

Journal of Pediatric and Adolescent Gynecology
Volume 20, Issue 2 , Pages 61-65, April 2007

Article Tools