Risk of contraceptive discontinuation among adolescents

Abstract

This prospective study assesses a sample of adolescent oral contraceptive users for correlates of continued use of birth control. Data were collected by interview at both an initial family planning clinic visit and 3 months later. Half of the sample did not return to the clinic for follow-up. Among those contacted by phone, all had discontinued the use of a contraceptive, and 69% were at risk for an unintended pregnancy. Least likely to continue to use the pill were adolescents who perceived substantial health-related problems associated with oral contraceptive use, felt their own risk of pregnancy was less than that of other teenagers, and had poor problem-solving skills. Among the most common problems experienced were the side effects associated with oral contraceptive use and difficulty remembering to take a pill every day. Suggested interventions aimed at supporting continued and effective use of birth control are provided.

PIP: This prospective study assesses a sample of adolescent oral contraceptive users from 3 clinics run by a private family planning agency in Oakland, California for correlates of continued use of birth control. Data were collected by interview at both an initial family planning clinic visit and 3 months later. 1/2 of the sample did not return to the clinic for follow-up. Among those contacted by phone, all had discontinued the use of a contraceptive, and 69% were at risk for an unintended pregnancy. Least likely to continue to use the pill were adolescents who perceived substantial health-related problems associated with oral contraceptive use, felt their own risk of pregnancy was less than that of other teenagers, and had poor problem-solving skills. Among the most common problems experienced were the side effects associated with oral contraceptive use and difficulty remembering to take a pill every day. Suggested interventions aimed at supporting continued and effective use of birth control include reassurance by staff, increased teaching of adolescents by practitioners to associate their pill-taking with another daily activity and to call the clinic should a side-effect occur. The typical medical protocol in family planning clinics requiring referral for additional tests may also interfere with some teenagers' continued use of birth control. Time spent in explaining the need for the tests and better follow-up will also enhance continuation.