SWLA Center for Health Services

SWLA Center for Health Services

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Candace. L. Douglas, MD OB/GYN

Welcomes Dr. Douglas

Though world-wide teen pregnancy rates have significantly declined over the past three decades, the United States is still ranked first among developed nations in rates of adolescent pregnancy and births.This remains an issue of national concern due to the long lasting impact it has on the lives of those affected.  Social factors, such as “low education and income levels of family, decreased opportunity for positive community involvement, and racially segregated and/or physically disordered neighborhoods” create a disparity that predisposes some youth to outcomes such as teen pregnancy. 2  Due to those circumstances, teen parents are often delayed in or unable to achieve their educational goals and earn less lifetime income, which can confine them to a life of continued socioeconomic disadvantage.3

 

The current downward trend in teen pregnancy rates has been attributed to improvements in both contraceptive use as well as comprehensive sexual education for adolescents.3,8  The importance of accessibility to contraception counseling/resources and sexual education is evidenced by the data which shows that young women were more than five times as likely to have had a teen birth by age 17 if they did not use a method of contraception at their first sexual intercourse (11%) than those who used a method (2%).4  This further emphasizes the impact of proper contraceptive use on pregnancy prevention efforts.

 

In recent years, the governing bodies within gynecology and pediatrics have encouraged the use of Long-Acting Reversible Contraceptive devices (LARCs) including the implant and IUD.3  Insertion of these devices has continued to steadily increase among adolescents and as a result, have decreased the human error component associated with contraceptive use (i.e. missed birth control pills or patches or late medroxyprogesterone injections). Those using LARCs are more likely to continue use at the 1-year mark as compared to other methods like birth control pills or patches.  Young women using those devices also had the highest satisfaction rates with their birth control method.5,6

 

While health care providers, parents, and teachers all play a role in the effort to prevent teen pregnancy, adolescents must take the most active role in their sexual health.

 

So what can teens do to combat teen pregnancy?

 

Never feel pressured to engage in sexual activity.

Everyone is not “doing it.” Research shows that the average age of first sexual activity is increasing which means teens are waiting longer to become sexually active. 4,7  Don’t let social or peer pressures dictate your decisions. Make the choice that is best for you.

 

Be informed.

Unintended pregnancy is not the only possible consequence of sexual activity. Exposure to sexually transmitted infections can also occur. While some infections can be cured with antibiotics, some cannot and will remain in your system for the rest of your life (e.g. HIV, HPV, and herpes). Being aware allows you to make informed decisions about your sexual health.

 

Talk to your provider about your contraceptive options.

Much of the decrease in teen pregnancy rates is due to improved use of birth control among sexually active teens.  There are many available options, many of which can be initiated at the first visit. The risks and benefits of these options can be reviewed in detail to find the one that best suits you.  In most cases, a pelvic exam is not necessary.5

 

Consider LARCs.

LARCs are long-acting reversible contraceptive devices which include the implant (Nexplanon®) and intrauterine device (Mirena®, Skyla®, Kyleena®, Paragard®).  These FDA approved contraceptive devices are safe for use in adolescents and have the lowest risk of unintended pregnancy with typical use. 5  They are user friendly in that they require one time dosing and last several years. 5

 

Use a dual method of protection.

Always use a barrier method of protection (i.e. condoms) not only as a back-up for pregnancy prevention, but also to prevent transmission of sexually transmitted infections.5

 

If already pregnant, seek prenatal care.

Early access to care allows for counseling regarding the current pregnancy as well as planning for the future including contraception management to prevent further unintended pregnancies.

 

 

Sources

 

  1. Martin JA, Hamilton BE, Osterman MJ, Driscoll AK, Mathews TJ. Births: final data for 2015. Natl Vital Stat Rep 2017;66:1. https://www.cdc.gov/nchs/data/nvsr/nvsr66/nvsr66_01.pdf. Retrieved April 20, 2018.

 

  1. Social determinants and eliminating disparities in teen pregnancy. https://www.cdc.gov/teenpregnancy/about/social-determinants-disparities-teen-pregnancy.htm. Retrieved April 20, 2018.

 

  1. Adolescent pregnancy, contraception, and sexual activity. Committee Opinion No. 699. American College of Obstetricians and Gynecologists. Obstet Gynecol 2017;120:983–8.

 

  1. Martinez GM and Abma JC, Sexual activity, contraceptive use, and childbearing of teenagers aged 15–19 in the United States, NCHS Data Brief, 2015, No. 209, https://www.cdc.gov/nchs/products/databriefs/db209.htm.

 

  1. Adolescents and long-acting reversible contraception: implants and intrauterine devices. Committee Opinion No. 539. American College of Obstetricians and Gynecologists. Obstet Gynecol 2012;120:983–8.

 

  1. Secura GMAllsworth JEMadden TMullersman JLPeipert JF. The Contraceptive CHOICE Project: reducing barriers to long-acting reversible contraception. Am J Obstet Gynecol.2010 Aug;203(2):115.e1-7. doi: 10.1016/j.ajog.2010.04.017. Epub 2010 Jun 11.

 

  1. Adolescent Sexual and Reproductive Health in the United States Fact Sheet, New York: Guttmacher Institute, 2017. https://www.guttmacher.org/fact-sheet/american-teens-sexual-and-reproductive-health. Retrieved April 20, 2018.

 

  1. Boonstra HD. What is behind the declines in teen pregnancy rates? Guttmacher Policy Rev 2014;17(3):15–21.

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