Postpartum contraceptive use among adolescent mothers in seven states

To describe postpartum contraceptive use among adolescent mothers and assess the hypothesis that receipt of prenatal contraceptive counseling or a postpartum checkup is associated with the use of more effective methods.

Data are from the Pregnancy Risk Assessment and Monitoring System for seven states and the city of New York for the years 2006-2008. The sample comprises 3,207 adolescent mothers aged 15-19 years. We conducted descriptive and multinomial logistic regression analyses. The outcome measure was the type of contraceptive method used at the time of the survey.

Nineteen percent of adolescent mothers, more than half of whom were sexually active, were using no contraception at the time of the survey. The remaining 81% were using a contraceptive method. Use of long-acting reversible contraception (LARC) was low-11% were using an intrauterine device, and only 1% were using an implant. Receipt of prenatal contraceptive counseling and receipt of a postpartum checkup were both associated with a decreased likelihood of having sex without contraception. A postpartum checkup was also associated with an increased likelihood of using medium-acting contraceptives (injectables, ring, or patch) and a decreased likelihood of relying on condoms. Prenatal contraceptive counseling was also associated with an increased likelihood of pill use.

Given the demonstrated association between LARC use and decreased rates of rapid repeat pregnancy, efforts should be made to increase adolescent mothers' access to LARC. Enhancing the scope and quality of prenatal contraceptive counseling and increasing the proportion of adolescent mothers who return for a postpartum checkup may also improve postpartum contraceptive use.