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Adolescents’ Contraceptive Use and Pregnancy History: Is There a Pattern?

From the Department of Obstetrics, Gynecology, and Reproductive Sciences, Center for Reproductive Health Research and Policy, University of California, San Francisco, California.

Address reprint requests to: Tina Raine, MD, MPH, San Francisco General Hospital 6D, 1001 Potrero, San Francisco, CA 94110; E-mail: tinar{at}ob.ucsf.edu.

OBJECTIVE: To examine the association between pregnancy experience and adolescents’ contraceptive use.

METHODS: We conducted a retrospective study of 920 sexually active adolescents not desiring pregnancy. Adjusted multivariable logistic regression analyses were used to assess the explanatory value of previous birth and abortion as well as first pregnancy at presentation on contraceptive practice.

RESULTS: Twenty-seven percent of the adolescents had been pregnant. Regardless of pregnancy history, 52% of adolescents used noneffective contraception (ie, condoms inconsistently or no method). Adolescents with previous abortion were three times (odds ratio [OR] 3.4, 95% confidence interval [CI] 1.6, 7.3) more likely than never-pregnant adolescents to use hormonal contraception. However, although more likely to use contraceptive injections or implants, adolescent mothers were not more likely than never-pregnant adolescents to use oral contraceptives. Adolescents with prior abortion or birth were less than half (ORs 0.3 and 0.4, 95% CIs 0.2, 0.5 and 0.2, 0.6, respectively) as likely as never-pregnant adolescents to use condoms consistently.

CONCLUSION: Previous pregnancy is associated with increased likelihood to use hormonal methods; however, a significant proportion of adolescents use noneffective methods and, thus, are at risk for repeat teenage pregnancies.

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				T. R. Raine, C. C. Harper, C. H. Rocca, R. Fischer, N. Padian, J. D. Klausner, and P. D. Darney Direct Access to Emergency Contraception Through Pharmacies and Effect on Unintended Pregnancy and STIs: A Randomized Controlled Trial JAMA, January 5, 2005; 293(1): 54 - 62. [Abstract] [Full Text] [PDF]