Abstract
The low rates of actual contraceptive failure and high rates of contraceptive use
among young women highlight that choice of contraceptive method and patterns of contraceptive
use greatly influence unintended pregnancy risk. Promoting contraceptive use among
adolescent and young adult women requires supportive health systems and health providers
who understand this population's evolving developmental needs. It also requires an
awareness of effective tools for counseling patients, while being mindful of the power
dynamics operational during clinical encounters to avoid inadvertently coercive interpersonal
dynamics. Missed opportunities to provide such patient-centered care can lead to unplanned
pregnancies and suboptimal health and social consequences for young women. Unfortunately,
health providers often lack the tools and resources to appropriately identify and
meet individual young women's contraceptive needs. This article summarizes the evidence
supporting contraceptive counseling strategies linked with contraceptive initiation
among young women, and evidence-based approaches for supporting contraceptive adherence
and continuation after method initiation. It also orients readers to the unique neurodevelopmental
factors that influence the shared decision-making process during contraception counseling
sessions with young women. New and emerging approaches for supporting contraceptive
initiation, adherence, and continuation are reviewed.
Key Words
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Article info
Publication history
Published online: December 14, 2020
Footnotes
This paper is the result of original work conducted by the co-authors and was not supported by external funding. Aletha Akers was a consultant for the Merck HPV Advisory Board, Mylan Women's Health Advisory Board, and Medicine360 during the time this manuscript was written. She had research funding from Bayer Healthcare and the Templeton Foundation for investigator-initiated grants through January 2020. The other authors report no proprietary or commercial interest in any product mentioned or concept discussed in this article.
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© 2021 Published by Elsevier Inc. on behalf of North American Society for Pediatric and Adolescent Gynecology.
ScienceDirect
Access this article on ScienceDirectLinked Article
- Contraceptive Counseling for Adolescents: Current Evidence and Road Map for the FutureJournal of Pediatric and Adolescent GynecologyVol. 34Issue 4
- PreviewThe past 3 decades have seen significant advancements in the area of adolescent contraceptive services and steady improvement in teen birth rates. Available contraceptive options have markedly increased. We have seen the expansion of short-acting hormonal contraceptive types, the entrance of long-acting reversable contraceptives, and the arrival of over-the-counter emergency contraception. Concurrent with this increase in contraceptive options and access, rates of teen births in the United States have steadily declined.
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