Short and long-term impact of adolescent pregnancy on postpartum contraceptive use: implications for prevention of repeat pregnancy☆
Accepted 11 March 2003.
Abstract
Purpose
To describe patterns and changes in contraceptive use among pregnant adolescents in early and later postpartum compared with nonpregnant adolescents.
Methods
One-hundred-seventy-six pregnant and 187 nonpregnant adolescents, recruited through community clinics, were interviewed three times (baseline, 6-month follow-up, 12-month follow-up) about their condom and hormonal contraceptive practices. Changes in contraception use and patterns of consistent hormonal and/or condom use were examined. Statistical analyses included General Estimating Equations (GEE) and multinomial regression.
Results
Pregnant adolescents increased hormonal contraceptive use from baseline to early postpartum, but decreased use from early postpartum to late postpartum. Nonpregnant adolescents did not change their hormonal contraceptive use over time. Neither group changed condom use over time. Pregnant adolescents were more likely to be consistent dual users and hormonal-only users during the 6-month follow-up compared with nonpregnant adolescents. These findings persisted at the 12-month follow-up, although there was a decline in hormonal contraception use.
Conclusions
Adolescents change their contraceptive use during the postpartum period. Given the slight decline in contraceptive use in late postpartum in this sample, more work is necessary to maintain motivation to continue these positive postpartum trends.
aYale University, Department of Epidemiology and Public Health, and Center for Interdisciplinary Research on AIDS (T.S.K., L.M.N., J.R.I., J.B.C.), New Haven, Connecticut, USA
bCenters for Disease Control and Prevention, Division of STD Prevention, Behavioral Interventions and Research Branch (K.A.E.), Atlanta, Georgia, USA
cYale University, Department of Psychology (J.R.I., C.S.M.), New Haven, Connecticut, USA
Address correspondence to: Trace S. Kershaw, Ph.D., Yale University Department of Epidemiology and Public Health, 135 College Street, Suite 323, New Haven, CT 06510, USA.
☆ This research was funded by the National Institute of Mental Health Grant P01 MH/DA56826-01A1 and Training Grant 1 T32 MH20031-02.
ABSTRACT