Abstract
Study Objective
Although long-acting reversible contraceptives (LARC) such as intrauterine devices
and subdermal implants remain the most effective methods of contraception for teenagers,
most adolescents continue to use less reliable methods. The purpose of this study
was to determine: (1) the distribution of contraceptive type according to age of the
patients in our clinic system (Baylor Teen Health Clinic); and (2) the differences
in this distribution over the past decade.
Design
This study was a comprehensive chart review of at least 15,500 charts for the years
2005 to 2014.
Setting
Baylor Teen Health Clinic.
Participants, Interventions, and Main Outcome Measures
Charts of patients less than 25 years of age who attended one of the 9 Baylor Teen
Health Clinics were reviewed. Contraceptive uptake by age and year was the main outcome
measured.
Results
The percentage of women younger than age 25 years who used LARC increased for all
age groups from 2005 to 2014, with the greatest increase for women 20-24 years old
(<1% to 9%). The percentage of women using no method decreased for all age groups
from 2005 to 2014 with the greatest decrease for women 15-19 years old (9% to 5%).
The percentage of women using less effective methods decreased for teenagers younger
than 18 years old, but increased for women 20-24 years old and remained the same for
women 18-19 years old. Use of pills/patches/rings decreased for all age groups and
use of hormonal injections increased for all age groups, with the greatest increase
for teenagers younger than 15 years of age (35% to 68%). Our clinic population has
a greater proportion of teenagers and young women using LARC than the national average,
possibly because of the increased access to LARC when these women enter our clinic
system. Nevertheless, less than 10% of all age groups studied used LARC, with the
proportion being lowest in teenagers younger than 18 years.
Conclusion
More efforts need to be placed on determining the reasons for low LARC uptake despite
greatest efficacy in this young, vulnerable population.
Key Words
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Article info
Publication history
Published online: May 21, 2019
Footnotes
This work was supported by the NICHD of the National Institutes of Health under award number K23HD086247-01A1.
The authors indicate no conflicts of interest.
Identification
Copyright
© 2019 Published by Elsevier Inc. on behalf of North American Society for Pediatric and Adolescent Gynecology.
