Postpartum Contraception Use among Adolescent Mothers

To describe patterns of postpartum contraception use among primiparous and multiparous adolescent mothers.

Cross-sectional data came from the Pregnancy Risk Assessment Monitoring System Phase 7 (2012-2015). The analytic sample included postpartum respondents ages 15-19 in 40 US states (N = 5535). Exposures included age, race, parity, intimate partner violence, psychosocial stressors, prenatal care utilization, postpartum home health visits, and insurance type. The primary outcome was postpartum use of effective contraception. The secondary outcome was reasons for not using postpartum contraception.

Adolescents who attended postpartum check-ups (AOR = 2.12; 95% CI 1.58-2.84) or received home health visits (AOR = 1.37; 95% CI 1.06-1.77) were more likely to use effective contraception postpartum, whereas those experiencing more stressors were less likely (AOR = 0.93; 95% CI: 0.86-1.00). Non-Hispanic Black adolescents were less likely to use effective contraception (AOR = 0.69; 95% CI 0.50-0.94) compared to non-Hispanic White adolescents. Among those who did not use contraception postpartum, having a postpartum home health visit was associated with lower odds of endorsing contraceptive side effects (AOR = 0.33; 95% CI 0.18-0.60) or not wishing to use contraception (AOR = 0.43; 95% CI 0.22-0.86) as reasons for nonuse.

Access to postpartum care via home health and postpartum clinic visits was associated with significantly higher likelihood of using effective contraception. However, disparities persisted among non-Hispanic Black adolescents and those experiencing high levels of psychosocial stress. For postpartum adolescents who do not desire a subsequent birth, increasing their ability to obtain effective contraceptives can be achieved through increased access to postpartum care, particularly for underserved populations.