Adolescent satisfaction with postpartum contraception and body weight concerns

Abstract

Purpose: To explore factors that could be related to adolescents' satisfaction with postpartum contraceptives.

Methods: Three focus groups were conducted with a total of 22 adolescent mothers. The groups covered four content areas: feelings about birth control since becoming a mother, decision making about contraceptive use, factors that would influence contraceptive discontinuation, and the perceived side effects of the current contraceptive. Audiotapes from the groups were analyzed to identify major themes.

Results: Nineteen subjects received Depo-Provera when they were discharged after delivery and the majority reported that menstrual irregularities and weight gain were side effects. Two body weight-related themes were dominant: dissatisfaction with heavier than desired body weights and resignation about not returning to prepregnancy weights.

Conclusions: Depo-Provera may be an effective contraceptive for adolescent mothers who are generally at high risk for rapid repeat pregnancy. This qualitative study suggests that contraceptive continuation may be enhanced with specific counselling to manage body weight concerns.

PIP: Factors having a potential effect on adolescents' use of and satisfaction with postpartum contraceptive methods were assessed in three focus groups involving 22 adolescent mothers of an infant under 12 months of age recruited from a Minnesota (US) clinic specializing in the prenatal and postpartum care of adolescent women. The average age of study participants was 17 years (range, 13-19 years). All adolescents chose to use contraception after delivery. 16 (73%) were using Depo-Provera, 3 were using oral contraceptives, and 3 were using condoms/foam. Most Depo-Provera users made their decision to accept this method with their prenatal care provider during pregnancy. Many had taken the pill at some point, but reported it was hard for them to take it every day. Despite concerns about side effects (especially increased hunger/weight gain and irregular menstrual bleeding), adolescent Depo-Provera acceptors preferred this method because it did not require daily compliance. 16 women (73%) considered themselves overweight, and they attributed this to both their pregnancy weight gain and their contraceptive method. Skepticism regarding their ability to lose weight through healthy eating and exercise was widespread. However, the desire to prevent another pregnancy through use of an effective method such as Depo-Provera was stronger than the desire to return to one's pre-pregnancy body weight. Overall, these adolescent mothers seemed resigned about their inability as a result of the demands of motherhood to resolve their malaise, fatigue, and sense of not being physically fit. These findings suggest a need for effective weight management and health-promoting programs for adolescent mothers that take into account their multiple role demands and generally limited financial resources.