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Comparative Study
. 2014 Oct 2;371(14):1316-23.
doi: 10.1056/NEJMoa1400506.

Provision of no-cost, long-acting contraception and teenage pregnancy

Gina M Secura  1 , Tessa Madden, Colleen McNicholas, Jennifer Mullersman, Christina M Buckel, Qiuhong Zhao, Jeffrey F Peipert
Affiliations
Comparative Study

Provision of no-cost, long-acting contraception and teenage pregnancy

Gina M Secura et al. N Engl J Med. .

Erratum in

  • N Engl J Med. 2014 Jan 15;372(3):297

Abstract

Background: The rate of teenage pregnancy in the United States is higher than in other developed nations. Teenage births result in substantial costs, including public assistance, health care costs, and income losses due to lower educational attainment and reduced earning potential.

Methods: The Contraceptive CHOICE Project was a large prospective cohort study designed to promote the use of long-acting, reversible contraceptive (LARC) methods to reduce unintended pregnancy in the St. Louis region. Participants were educated about reversible contraception, with an emphasis on the benefits of LARC methods, were provided with their choice of reversible contraception at no cost, and were followed for 2 to 3 years. We analyzed pregnancy, birth, and induced-abortion rates among teenage girls and women 15 to 19 years of age in this cohort and compared them with those observed nationally among U.S. teens in the same age group.

Results: Of the 1404 teenage girls and women enrolled in CHOICE, 72% chose an intrauterine device or implant (LARC methods); the remaining 28% chose another method. During the 2008-2013 period, the mean annual rates of pregnancy, birth, and abortion among CHOICE participants were 34.0, 19.4, and 9.7 per 1000 teens, respectively. In comparison, rates of pregnancy, birth, and abortion among sexually experienced U.S. teens in 2008 were 158.5, 94.0, and 41.5 per 1000, respectively.

Conclusions: Teenage girls and women who were provided contraception at no cost and educated about reversible contraception and the benefits of LARC methods had rates of pregnancy, birth, and abortion that were much lower than the national rates for sexually experienced teens. (Funded by the Susan Thompson Buffett Foundation and others.).

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Conflict of interest statement

No other potential conflict of interest relevant to this article was reported.

Figures

Figure 1
Figure 1. Pregnancy, Birth, and Abortion Rates among U.S. Teenage Girls and Women, as Compared with CHOICE Participants, Stratified According to Age and Race
Figure 2
Figure 2. Pregnancy Rates among Sexually Experienced U.S. Teenage Girls and Women, as Compared with CHOICE Participants, Stratified According to Age and Race
Data for the 2008 U.S. rates stratified according to age and race are from K. Kost, Guttmacher Institute (personal communication).
See this image and copyright information in PMC

References

    1. Kost K, Henshaw SK. US teenage pregnancies, births and abortions 2010: national and state trends by age, race and ethnicity. New York: Guttmacher Institute; 2014. http://www.guttmacher.org/pubs/USTPtrends10.pdf.
    1. The National Campaign to Prevent Teen and Unplanned Pregnancy. Fast facts: how is the 3 in 10 statistic calculated? 2011 Feb; http://grist.files.wordpress.com/2011/10/fastfacts_3in10.pdf.
    1. The National Campaign to Prevent Teen and Unplanned Pregnancy. Fast facts: teen pregnancy and childbearing among Latina teens. 2013 Dec; https://thenationalcampaign.org/sites/default/files/resource-primary-dow....
    1. The National Campaign to Prevent Teen and Unplanned Pregnancy. Fast facts: teen pregnancy and childbearing among non-Hispanic black teens. 2013 Dec; http://thenationalcampaign.org/sites/default/files/resource-primary-down....
    1. The National Campaign to Prevent Teen and Unplanned Pregnancy. Counting it up: the public costs of teen child-bearing — key data. 2013 Dec; https://thenationalcampaign.org/sites/default/files/resource-primary-dow....

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