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Short and long-term impact of adolescent pregnancy on postpartum contraceptive use: implications for prevention of repeat pregnancy.
Journal of Adolescent Health 2003;33(5):359-368.
Kershaw TS, Niccolai LM, Ickovics JR, Lewis JB, Meade CS, Ethier
KA.
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.