Empowering Adolescent Mothers in the Choice of Contraception at Postpartum Period: Avoiding a Subsequent Pregnancy

Abstract

Background: Almost 80% of adolescent pregnancies are unplanned and 28-63% of adolescent mothers had a repeated pregnancy within 18 months. Among girls with repeated pregnancies, two-thirds reported that the pregnancy was unplanned. We aim to assess contraceptive use by adolescents mothers with increasing choice for LARC methods in postpartum consultation after a semi-structured group intervention involving adolescent mothers. Methods: Retrospective observational study conducted at University of Campinas, Brazil. The intervention involved antenatal and postpartum education groups for adolescents. At postpartum consultations, the adolescents chose their contraception. The data was compared to previous series followed in a period before the education group's implementation - an historical control group. Findings: We included 129 adolescent after childbirth from January 1st, 2015 through July 31st, 2017. Contraception methods before pregnancy were ever-used by 63%, and the most frequent method was combined oral contraceptives (33%) followed by condoms (21%). At the first postpartum consultation, the most common contraceptive chosen was IUC (37.2%) and depot-medroxyprogesterone acetate (DMPA) (34.1%). When comparing the rates before and after the education interventions - there was a 3-fold increase in IUC use. Interpretation: Antenatal and postpartum education increased the choice of IUCs by adolescents. Funding Statement: This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors. Declaration of Interests: The authors declare no conflict of interests Ethics Approval Statement: A retrospective observational study was performed at the Department of Obstetrics and Gynaecology, School of Medical Sciences University of Campinas (UNICAMP), Campinas, SP, Brazil. Ethical Committee of the University of Campinas approved this research (CAAE: 1909413.6.0000.5404). All items of the Strengthening the Reporting of Observational Studies in Epidemiology were followed.