Abstract
Study Objective
To determine if teenage patients receiving prenatal care in an adolescent-focused
clinic, emphasizing long-acting reversible contraception (LARC) using motivational
interviewing techniques, had higher rates of uptake of postpartum LARC than a control
group.
Design and Setting
Retrospective cohort study comparing young women who received prenatal care in an
adolescent-focused setting with those enrolled in standard prenatal care.
Participants
Adolescents between the ages of 13 and 17 years receiving prenatal care within the
Maricopa Integrated Health safety-net system between 2007 and 2014.
Interventions
Motivational interviewing within the context of adolescent-focused prenatal care.
Main Outcome Measures
Rates of uptake of LARC within 13 postpartum weeks.
Results
The adjusted rate of LARC for adolescent-focused prenatal care participants by 13 weeks
postpartum was 38% (95% confidence interval [CI], 29%-47%) compared with 18% (95%
CI, 11%-28%) for standard care participants, with an adjusted odds ratio of LARC use
of 2.8 (95% CI, 1.5-5.2). Among patients who received adolescent-focused prenatal
care, most (27% vs 12.7%) were using an intrauterine device as opposed to an implantable
contraceptive device.
Conclusion
Participation in an adolescent-focused antepartum setting using motivational interviewing
to emphasize postpartum LARC resulted in nearly 3 times higher rates of uptake compared
with standard prenatal care.
Key Words
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Article info
Publication history
Published online: November 18, 2016
Footnotes
The authors indicate no conflicts of interest.
Identification
Copyright
© 2016 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc.
