Short and long-term impact of adolescent pregnancy on postpartum contraceptive use: implications for prevention of repeat pregnancy.
OBJECTIVE
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.
Kershaw
Trace S
TS
Yale University, Department of Epidemiology and Public Health, and Center for Interdisciplinary Research on AIDS, New Haven, Connecticut 06510, USA. trace.kershaw@yale.edu
Niccolai
Linda M
LM
Ickovics
Jeannette R
JR
Lewis
Jessica B
JB
Meade
Christina S
CS
Ethier
Kathleen A
KA
D000293:Adolescent; D017280:Condoms / Q000706:statistics & numerical data*; D003237:Connecticut; D003268:Contraception Behavior / Q000208:ethnology / Q000523:psychology*; D003278:Contraceptives, Oral, Hormonal / Q000627:therapeutic use*; D005193:Family Planning Services / Q000706:statistics & numerical data; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D009035:Mothers / Q000523:psychology*; D049590:Postpartum Period / Q000523:psychology*; D011247:Pregnancy; D011253:Pregnancy in Adolescence / Q000517:prevention & control / Q000523:psychology; D012044:Regression Analysis; D012959:Socioeconomic Factors
D003278:Contraceptives, Oral, Hormonal