Original Report| Volume 34, ISSUE 4, P484-490, August 2021

What's Known and What's Next: Contraceptive Counseling and Support for Adolescents and Young Adult Women

  • Andrea J. Hoopes
    The Adolescent Center, Adolescent Medicine, Kaiser Permanente Washington, Bellevue, Washington
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  • C. Alix Timko
    Eating Disorder Assessment and Treatment Program, Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania

    Perelman School of Medicine at The University of Pennsylvania, Philadelphia, Pennsylvania

    The PolicyLab at the Roberts Center for Pediatric Research, Philadelphia, Pennsylvania
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  • Aletha Y. Akers
    Address correspondence to: Aletha Y. Akers, MD, MPH, FACOG, FSAHM, Vice President for Research, Guttmacher Institute, 125 Maiden Lane, 7th Floor, New York, NY 10038; Phone: (212) 248-1111; fax: (212) 248-1951
    Adolescent Gynecology Consultative Service, The Craig Dalsimer Division of Adolescent Medicine, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
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Published:December 14, 2020DOI:


      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.

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      Linked Article

      • Contraceptive Counseling for Adolescents: Current Evidence and Road Map for the Future
        Journal of Pediatric and Adolescent GynecologyVol. 34Issue 4
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          The 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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