Contraceptive use among high-risk adolescents.

Abstract

Despite awareness of the growing number of pregnant teens in the US, little information has been published concerning factors that predict early childbirth among individual girls. To begin to address this issue, the influence of specific life and social factors was examined in 50 adolescent girls with documented histories of good and poor contraception use. Patients selected for participation were 50 indigent nulliparous adolescent and young adult females from 14-22 years old receiving health care at the Teen Health Clinic at the Jefferson Davis Hospital in Houston, Texas. 25 adolescents who indicated that they had been able to use oral contraception prescribed by the clinic for at least 6 months without major problems or complaints were classified as good contraceptors. 25 adolescents assigned to the poor contraceptors group were those who missed 2 or more appointments in a 6-month interval, experienced at least one suspected pregnancy during this time, and indicated verbally that they had not been completely compliant. Each subject was assessed with a structured interview consisting of 25 questions on the patient's past history of contraception, school performance, family birth, employment, residence patterns, and accessibility to contraceptive services. Data from each of the 25 questions of the interview were pooled for the good and poor contraceptors. Where applicable, Chi-square frequency tests and t-tests were used to determine whether differences were statistically significant. Some of the results follow. 1) Reasons for occasional nonuse of oral contraception in the 12 months prior to the interview were assessed in both samples; no statistical differences were observed. The majority of nonusers attributed it to a random event, such as a memory lapse. 2) Sources of birth control education were equivalent in the 2 groups. 3) Good contraceptors reported intercourse 2.6 times/month, as compared to 4.7 times/month for poor contraceptors. 4) 3 of 25 good contraceptors had dropped out of school, while 9 out of 25 poor contraceptors had left school. 5) 72% of the good contraceptors intended to complete at least 2 years of college, but only 52% of the poor contraceptors did. 6) Poor contraceptors had a greater frequency of sisters who had become pregnant relative to good contraceptors. 7) Good contraceptors were more likely to be employed either part- or full-time (52%) than were the poor contraceptors (28%). 8) Good contraceptors reported fewer changes in residence relative to the poor contraceptors in the preceding 5 years. 9) Poor contraceptors had significantly longer travel times to the clinic (mean of 54.5 minutes) relative to good contraceptors (mean of 33 minutes).