Preventing teenage pregnancy

Abstract

Teenage pregnancy is still a medical and economic concern. Early anticipatory counseling with an emphasis on abstinence is helpful. Contraception information and sexually transmitted disease prevention should be part of the counseling. This article reviews common contraception methodology.

PIP: The topic of preventing adolescent pregnancy in developed countries is introduced by noting that 1) adolescent pregnancy in the US, the UK, and Canada is associated with financial dependence on social services and with increased health risks for the mother and child; 2) these negative outcomes call for preventive efforts that target adolescents at risk and provide contraceptive information to adolescents at an early age; 3) poverty is the most prevalent risk factor; and 4) one screening technique, dubbed HEADS, considers home life, education, activities, drug use, sex behavior, and suicidal tendencies. After recommending that primary care givers first emphasize abstinence and then give accurate and complete information about contraceptive methods, the remainder of the article reviews the following methods: barrier methods, IUDs, oral contraceptives (OCs), Norplant, injectable progesterone, and postcoital (emergency) contraception. The text is illustrated with tables that 1) compare female barrier methods, 2) describe OC contraindications, 3) compare hormonal components in common OCs, 4) list the contraindications to Norplant, 5) show OC noncompliance rates among adolescents, 6) show barrier method noncompliance rates among adolescents, and 7) illustrate the failure rates of different contraceptive methods. The article concludes by recommending that counseling on prevention of sexually transmitted diseases should accompany contraceptive counseling and by noting that increased knowledge is not associated with increased sex behavior or decreased age of initial intercourse.