Short and long-term impact of adolescent pregnancy on postpartum contraceptive use: implications for prevention of repeat pregnancy

Kershaw, Trace S; Niccolai, Linda M; Ickovics, Jeannette R; Lewis, Jessica B; Meade, Christina S; Ethier, Kathleen A

doi:10.1016/S1054-139X(03)00138-1

« Previous Next »Journal of Adolescent Health
Volume 33, Issue 5 , Pages 359-368, November 2003

Short and long-term impact of adolescent pregnancy on postpartum contraceptive use: implications for prevention of repeat pregnancy☆

Trace S Kershaw, Ph.D.
- Address correspondence to: Trace S. Kershaw, Ph.D., Yale University Department of Epidemiology and Public Health, 135 College Street, Suite 323, New Haven, CT 06510, USA.
- Yale University, Department of Epidemiology and Public Health, and Center for Interdisciplinary Research on AIDS (T.S.K., L.M.N., J.R.I., J.B.C.), New Haven, Connecticut, USA
Linda M Niccolai, Ph.D.
- Yale University, Department of Epidemiology and Public Health, and Center for Interdisciplinary Research on AIDS (T.S.K., L.M.N., J.R.I., J.B.C.), New Haven, Connecticut, USA
Jeannette R Ickovics, Ph.D.
- Yale University, Department of Epidemiology and Public Health, and Center for Interdisciplinary Research on AIDS (T.S.K., L.M.N., J.R.I., J.B.C.), New Haven, Connecticut, USA
- Yale University, Department of Psychology (J.R.I., C.S.M.), New Haven, Connecticut, USA
Jessica B Lewis, Ph.D.
- Yale University, Department of Epidemiology and Public Health, and Center for Interdisciplinary Research on AIDS (T.S.K., L.M.N., J.R.I., J.B.C.), New Haven, Connecticut, USA
Christina S Meade, Ph.D.
- Yale University, Department of Psychology (J.R.I., C.S.M.), New Haven, Connecticut, USA
Kathleen A Ethier, Ph.D.
- Centers for Disease Control and Prevention, Division of STD Prevention, Behavioral Interventions and Research Branch (K.A.E.), Atlanta, Georgia, USA

Accepted 11 March 2003.

Abstract

Purpose

To describe patterns and changes in contraceptive use among pregnant adolescents in early and later postpartum compared with nonpregnant adolescents.

Methods

One-hundred-seventy-six pregnant and 187 nonpregnant adolescents, recruited through community clinics, were interviewed three times (baseline, 6-month follow-up, 12-month follow-up) about their condom and hormonal contraceptive practices. Changes in contraception use and patterns of consistent hormonal and/or condom use were examined. Statistical analyses included General Estimating Equations (GEE) and multinomial regression.

Results

Pregnant adolescents increased hormonal contraceptive use from baseline to early postpartum, but decreased use from early postpartum to late postpartum. Nonpregnant adolescents did not change their hormonal contraceptive use over time. Neither group changed condom use over time. Pregnant adolescents were more likely to be consistent dual users and hormonal-only users during the 6-month follow-up compared with nonpregnant adolescents. These findings persisted at the 12-month follow-up, although there was a decline in hormonal contraception use.

Conclusions

Adolescents change their contraceptive use during the postpartum period. Given the slight decline in contraceptive use in late postpartum in this sample, more work is necessary to maintain motivation to continue these positive postpartum trends.

Keywords: Adolescents, Condom use, Reproductive health