Every Saturday the CSPH highlights news or recent research in the field of human sexuality. This week we’re looking at a qualitative study on adolescent females’ access to and use of contraceptives after their first pregnancy.
In their study, published December 2011 in Perspectives on Sexual and Reproductive Health, researchers Ellen K. Wilson, Ghazaleh Samandari, Helen P. Koo, and Christine Tucker cite that in the U.S., 400,000 teenagers give birth every year and that one-fifth of teenage births are to adolescents who already have children. They also cite that “rapid repeat pregnancy” in teenagers increases the likelihood of mothers not returning to school or being able to support themselves financially and the likelihood of emotional and behavioral problems in their children. Effective contraceptive use in first-time mothers can reduce the risk of a rapid repeat pregnancy and the associated negative maternal and child health outcomes. It has been found that many adolescent mothers begin using a highly effective method after delivery; however, their rates of contraceptive discontinuation are high. This research sought to gain information regarding the factors that influence female adolescents’ use of contraception after their first pregnancy.
Interviews were conducted with a group of black, white and Latina adolescent first-time mothers and with professionals who work closely with adolescent mothers. The interviews explored adolescent mothers’ health behaviors, including contraceptive use, before and after pregnancy. The researchers found that teenagers’ use of contraceptives increased after pregnancy due to “clarity of intention to avoid pregnancy and improved contraceptive knowledge, support and access after delivery,” however, this increased access usually did not continue for long, and levels of contraceptive method switching were high. The participants cited several barriers to postpartum contraceptive use including lack of information and parental support, as well as the loss of Medicaid and continuity of care. Ultimately, the researchers found that after giving birth, the teens demonstrated strong intention to use contraceptives in order to prevent a second pregnancy, but due to limited access to contraceptive services in the months after giving birth, many teens either discontinued the use of contraception or switched methods.
In light of their findings, the authors recommend that teenagers, families, and medical providers strengthen the link to family planning services without disruption after the teen gives birth in order to prevent gaps in contraceptive coverage and subsequent unintended pregnancy. They also recommend that Medicaid coverage include family planning coverage for teenagers (19 and younger) so they are able to pay for effective birth control methods.
While this research and the authors’ recommendations focus issues of access and education postpartum, the information gained from this study also supports the need for improved sexual education and increased access to contraceptives for all teenagers. Almost every participant in this study reported that they had either “not intended” or only “partly intended” to get pregnant while they were sexually active. Another portion of the participants reported that they were not even thinking about issues of pregnancy while engaging in sexual intercourse (whether using or not using contraceptives). Another important element is that in addition to preventing unwanted pregnancy, improved education and access to contraceptives can help prevent sexually transmitted infections in teenagers – both those that have never been pregnant and those who have children.
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