Purpose To identify provider and practice characteristics associated with long-acting reversible contraception (LARC – progesterone contraceptive implants or IUDs [intrauterine devices]) provision among adolescent health care providers. Methods We analyzed physician characteristics and self-reported provision of LARC using chi-square analyses. Multivariate logistic regressions identified factors predicting provision of any form of LARC, as well as progesterone contraceptive implants or IUDs specifically. Results In logistic regressions, residency training in obstetrics/gynecology or family medicine (rather than internal medicine/pediatrics) was the strongest predictor of LARC provision, particularly for IUDs. Practicing in suburban (rather than urban) and hospital-based (rather than private) settings was associated with lower and higher likelihoods of providing LARC respectively. Conclusions Exposure to procedural women’s health training was the strongest predictor LARC provision. Increasing the number of providers offering this type of contraception may have broad reaching consequences for adolescent pregnancy prevention, and may be most easily accomplished via contraceptive implants.

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Background Adolescents are at high risk of unintended pregnancy due to contraceptive nonuse and inconsistent use. Study Design We examined associations between contraception and mistimed/unwanted birth among adolescents. For contraceptive nonusers, we analyzed factors contributing to unintended birth. Results Half of adolescents with unintended births did not use contraception at conception. Those ambivalent about pregnancy reported fewer unwanted [relative risk (RR)=0.06] compared to wanted births. Amongst contraceptive nonusers, difficulty accessing birth control was the only factor associated with more unwanted birth (RR=3.05). For Black adolescents, concerns of side effects (RR=7.03), access issues (RR=10.95) and perceived sterility (RR=3.20) were associated with unwanted birth. For younger teens, falsely perceived subfertility increased unwanted birth (RR=2.74), whereas access issues were significant for older teens (RR=3.97). Conclusions Access issues and misconceptions around contraceptive side effects and fertility place adolescents at higher risk for unintended pregnancy, especially among younger and Black teens. Ambivalence represents an additional area for intervention.

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