title: A randomized controlled trial of the effect of advanced supply of emergency contraception in postpartum teens: a feasibility study.
abstract: BACKGROUND
  The study was conducted to test the feasibility of conducting a randomized controlled contraceptive trial in postpartum teens and to assess whether postpartum advanced supply of emergency contraception (EC) to teenaged mothers helps to prevent repeat pregnancies of close proximity.
  
  
  METHODS
  We performed a randomized controlled trial of 50 postpartum teens at an urban academic medical center. Participants in the intervention arm received routine postpartum contraceptive care and advanced supply of one pack of EC pills with unlimited supply thereafter upon request. The routine care arm (RCA) received routine postpartum contraceptive care. We asked open-ended questions about how we might maximize study retention and implemented the participants' requests in both arms.
  
  
  RESULTS
  Our retention rate was 78%. There were three (13%) pregnancies out of 23 participants in the intervention arm and eight (30%) pregnancies out of 27 participants in the RCA. The risk of pregnancy occurring in the intervention arm was 0.57 times that of the RCA (95% CI 0.20-1.60; p=.23).
  
  
  CONCLUSIONS
  A randomized controlled trial of postpartum teens to receive and not to receive advanced supply of EC is both feasible and necessary. Our study provides preliminary data to suggest that advanced supply of EC may help decrease repeat teen pregnancies.
authors.affiliation: Department of Obstetrics and Gynecology, University of Pennsylvania School of Medicine, Philadelphia, PA 19104, USA. cschreiber@obgyn.upenn.edu
authors.forename: Courtney A
authors.initials: CA
authors.lastname: Schreiber
authors.forename: Sarah J
authors.initials: SJ
authors.lastname: Ratcliffe
authors.forename: Kurt T
authors.initials: KT
authors.lastname: Barnhart
mesh_terms: D000046:Academic Medical Centers; D000293:Adolescent; D003075:Coitus; D044363:Contraception, Postcoital / Q000706:statistics & numerical data; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D049590:Postpartum Period; D011247:Pregnancy; D011253:Pregnancy in Adolescence / Q000517:prevention & control* / Q000706:statistics & numerical data; D014505:Urban Population; D055815:Young Adult