Contraception for Adolescents

Abstract

Contraception is a pillar in reducing adolescent pregnancy rates. The American Academy of Pediatrics recommends that pediatricians develop a working knowledge of contraception to help adolescents reduce risks of and negative health consequences related to unintended pregnancy. Over the past 10 years, a number of new contraceptive methods have become available to adolescents, newer guidance has been issued on existing contraceptive methods, and the evidence base for contraception for special populations (adolescents who have disabilities, are obese, are recipients of solid organ transplants, or are HIV infected) has expanded. The Academy has addressed contraception since 1980, and this policy statement updates the 2007 statement on contraception and adolescents. It provides the pediatrician with a description and rationale for best practices in counseling and prescribing contraception for adolescents. It is supported by an accompanying technical report.

Strengthening implant provision and acceptance in South Africa with the ‘Any woman, any place, any time’ approach: An essential step towards reducing unintended pregnancies

“…[9] Indeed, professional bodies in the USA recommend that providers must emphasise that LARCs are 'the best reversible methods for preventing unintended pregnancy, rapid repeat pregnancy, and abortion in young women' . [10,11] In SA, Implanon is currently used to provide pregnancy protection for 3 years, but increasingly evidence suggests that protection may extend to 5 years, even in women with a high body mass index. [12,13] Prolonged effectiveness would further improve Implanon's convenience for women, and reduce removal procedures and costs of implant replacements.…”

Introduction of the contraceptive implant in South Africa: Successes, challenges and the way forward

“…Moreover, only about a quarter remembered being informed about the method's remarkable contraceptive effectiveness, the attribute that takes centre-place in family-planning counselling in many other countries. [6,7] Models, leaflets and flip charts can be used to facilitate such discussions. [8] In many settings, information about contraceptive methods is simply presented verbally -from most to least effective, beginning with the implant.…”

“…[8] In many settings, information about contraceptive methods is simply presented verbally -from most to least effective, beginning with the implant. [6,7] Among women who experience heavy or prolonged bleeding while using the implant, the decision to continue the method seems contingent on the dynamics of their relationship with their partner and the level of sexual activity. These issues need to be foregrounded in counselling for this group of women.…”

“…In many settings, the implant is considered as 'first-line' for women within 48 hours of childbirth or after an abortion, as well as for adolescents and young women. [6,[11][12][13] The study by Pillay et al, [3] however, found no evidence that the youth were being targeted; only ~15% of participants were aged 18 -24 years, the age group with the highest unmet need for contraception. [1,14] Targeted implant provision is needed and creative approaches are called for.…”

Counseling Adolescents About the Intrauterine Contraceptive Device

“…4,5 Professional medical guidelines support IUDs as a first line contraceptive for adolescents. 6–9 Yet only 4.5% of contracepting U.S. adolescents have an IUD. 10 …”