title: Postpartum adolescents' contraceptive counselling preferences.
abstract: OBJECTIVE
  The optimal approach for provision and timing of postpartum contraceptive counselling for adolescents has not been established. To reduce repeat pregnancies from current USA levels of nearly 20%, a better understanding is needed of postpartum adolescent females' preferences regarding contraceptive counselling and delivery.
  
  
  METHODS
  Semi-structured interviews with 30 USA postpartum teens (97% Black) explored pregnancy prevention and contraceptive counselling. Transcripts were independently coded by two researchers and inter-rater reliability calculated using Kappa coefficients. With a standard content analysis approach, common themes were identified, coded and summarized.
  
  
  RESULTS
  Findings indicated pregnancy prevention was important - two thirds of subjects reported becoming pregnant 'too soon', almost all did not desire another child for at least 6 years and most indicated that pregnancy prevention was either 'very' or 'extremely' important right now. The subjects described doctors and their prenatal clinic as their most accurate sources of contraception information, but stated that doctors and parents were the most helpful sources. All were comfortable discussing contraception with providers and had a desire for shared decision making. While many had received written materials, most preferred in-person contraceptive counselling. Optimally, participants suggested that contraceptive counselling would be provided by a physician, begin antepartum and almost all preferred to leave the hospital with their chosen method of contraception.
  
  
  CONCLUSIONS
  Pregnancy prevention is important for postpartum adolescents as most desired to delay future childbearing. In-person contraceptive counselling should begin in the antepartum period and include provision of contraception prior to discharge.
authors.affiliation: a Department of Obstetrics and Gynaecology , School of Medicine, University of Pennsylvania , Philadelphia , PA , USA.
authors.forename: Stephanie
authors.initials: S
authors.lastname: Sober
authors.affiliation: b Department of Medicine , School of Medicine, University of Pennsylvania , Philadelphia , PA , USA.
authors.forename: Judy A
authors.initials: JA
authors.lastname: Shea
authors.affiliation: c Sidney Kimmel College of Medicine, Thomas Jefferson University , Philadelphia , PA , USA.
authors.forename: Allison G
authors.initials: AG
authors.lastname: Shaber
authors.affiliation: a Department of Obstetrics and Gynaecology , School of Medicine, University of Pennsylvania , Philadelphia , PA , USA.
authors.forename: Paul G
authors.initials: PG
authors.lastname: Whittaker
authors.affiliation: a Department of Obstetrics and Gynaecology , School of Medicine, University of Pennsylvania , Philadelphia , PA , USA.
authors.forename: Courtney A
authors.initials: CA
authors.lastname: Schreiber
mesh_terms: D000293:Adolescent; D016497:Adolescent Health Services; D003271:Contraceptive Agents, Female / Q000627:therapeutic use*; D003376:Counseling; D005260:Female; D006801:Humans; D017258:Medroxyprogesterone Acetate / Q000627:therapeutic use*; D017060:Patient Satisfaction; D049590:Postpartum Period / Q000523:psychology*; D011247:Pregnancy; D011253:Pregnancy in Adolescence
chemical_list: D003271:Contraceptive Agents, Female; D017258:Medroxyprogesterone Acetate
keywords: LARC; Postpartum; adolescents; contraception; qualitative; survey