SAN ANTONIO — The number of unintended subsequent teenage pregnancies might decrease with enhanced postpartum contraceptive counseling, particularly about side effects of birth control options, based on findings from a telephone survey of 40 young women.
The survey, conducted at 7 months to 1 year post partum, included women aged 21 years and younger who were delivered between April and September 2007 at Sinai Hospital in Baltimore, said Dr. Suzanne Elizabeth Jose and Dr. Julie Jacobstein.
“We see a lot of 15-year-old, 16-year-old girls coming in with their second or third babies,” Dr. Jose said in an interview. “Before they leave the hospital, we counsel them about birth control options.” The most common contraceptive choices were the birth control pill (13 patients) and injectable contraception (10 patients).
“But they come back. So we asked ourselves: What are we doing wrong?” Dr. Jose said at her poster during the annual meeting of the North American Society for Pediatric and Adolescent Gynecology.
All of the surveyed patients reported receiving some counseling, but half had discontinued contraception. “Some had no reason—they just stopped.” Others cited adverse effects.
“We have to improve our counseling about side effects,” Dr. Jose said. Group contraception counseling is a possible strategy.
When talking to adolescents, “you have to be able to talk to them in language they understand,” and a planned study will explore age-appropriate dialogue, Dr. Jose said. The routine 6-week follow-up visit after vaginal deliveries might be a good time to reinforce contraceptive counseling, she added.
Of the 40 adolescent mothers, 11 (28%) reported a subsequent pregnancy—all unintended, Dr. Jose said. There were no miscarriages or ectopic pregnancies.
Although it did not occur in this study, some adolescents choose to get pregnant again, she said. Physicians can ask about such plans during contraceptive counseling and consider the duration of different options. For example, an intrauterine device that lasts 5 years may not be a good option for a teenager.
Next, Dr. Jose and her associates plan to study the effectiveness of postpartum contraceptive counseling in a prospective study.
Dr. Jose said she had no relevant financial disclosures.
The 6-week follow-up visit after vaginal deliveries might be a good time to reinforce counseling. DR. JOSE