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Contraception and Adolescent Pregnancy

By

Sharon Levy

, MD, MPH, Harvard Medical School

Last full review/revision Jul 2022| Content last modified Jul 2022
CLICK HERE FOR THE PROFESSIONAL VERSION

Many adolescents engage in sexual activity but may not be fully informed about contraception Overview of Contraception Contraception is prevention of fertilization of an egg by a sperm (conception) or prevention of attachment of the fertilized egg to the lining of the uterus ( implantation). Contraception (birth... read more , pregnancy Medical Care During Pregnancy Ideally, a couple who is thinking of having a baby should see a doctor or other health care practitioner to discuss whether pregnancy is advisable. Usually, pregnancy is very safe. However,... read more , and sexually transmitted infections Overview of Sexually Transmitted Infections (STIs) Sexually transmitted (venereal) diseases are infections that are typically, but not exclusively, passed from person to person through sexual contact. Sexually transmitted infections may be caused... read more Overview of Sexually Transmitted Infections (STIs) , including hepatitis C Hepatitis C, Acute Acute hepatitis C is inflammation of the liver that is caused by the hepatitis C virus and that lasts from a few weeks up to 6 months. Hepatitis C is spread through contact with blood or other... read more and human immunodeficiency virus (HIV) infection Human Immunodeficiency Virus (HIV) Infection Human immunodeficiency virus (HIV) infection is a viral infection that progressively destroys certain white blood cells and can cause acquired immunodeficiency syndrome (AIDS). HIV is transmitted... read more Human Immunodeficiency Virus (HIV) Infection . Impulsivity, lack of planning, and concurrent drug and alcohol use decrease the likelihood that adolescents will use birth control and barrier protection (such as condoms).

Contraception in adolescents

Any of the adult contraceptive methods Overview of Contraception Contraception is prevention of fertilization of an egg by a sperm (conception) or prevention of attachment of the fertilized egg to the lining of the uterus ( implantation). Contraception (birth... read more may be used by adolescents, but the most common problem is adherence. For example, some adolescent girls forget to take birth control pills Oral Contraceptives Contraceptive hormones can be Taken by mouth (oral contraceptives) Inserted into the vagina (vaginal rings) Applied to the skin (patch) Implanted under the skin read more Oral Contraceptives every day or stop taking them entirely and may not substitute another form of birth control. Although male condoms are the most frequently used form of contraception, there are still perceptions that may inhibit consistent use. For example, adolescents may think condoms decrease pleasure and interfere with “romantic love.” Some adolescents also are shy about asking partners to use condoms during sex. Longer-term forms of contraception, such as intrauterine devices ( IUDs Intrauterine Devices (IUDs) Intrauterine devices (IUDs) are small, flexible, T-shaped plastic devices that are inserted into the uterus. An IUD is left in place for 3, 5, 7, or 10 years, depending on the type, or until... read more Intrauterine Devices (IUDs) ), hormonal injections Contraceptive Injections Contraceptive hormones can be Taken by mouth (oral contraceptives) Inserted into the vagina (vaginal rings) Applied to the skin (patch) Implanted under the skin read more Contraceptive Injections that last 3 months or longer, or implants under the skin Contraceptive Implants Contraceptive hormones can be Taken by mouth (oral contraceptives) Inserted into the vagina (vaginal rings) Applied to the skin (patch) Implanted under the skin read more Contraceptive Implants that may be effective for several years, are popular with adolescent girls.

Adolescent pregnancy

Pregnancy can be a source of significant emotional stress for adolescents.

Pregnant adolescents and their partners tend to drop out of school or job training, thus worsening their economic status, lowering their self-esteem, and straining personal relationships. Pregnant adolescents are less likely than adults to get prenatal care, resulting in poorer pregnancy outcomes, such as higher rates of premature birth Premature Newborn A premature newborn is a baby delivered before 37 weeks of gestation. Depending on when they are born, premature newborns have underdeveloped organs, which may not be ready to function outside... read more . Pregnant adolescents, particularly the very young and those who are not receiving prenatal care, are more likely than women in their 20s to have medical problems such as anemia Anemia During Pregnancy Anemia occurs in up to one third of women during the 3rd trimester. The most common causes of anemia are Iron deficiency Folate deficiency (See also Anemia.) If women have a hereditary anemia... read more (when the body does not have enough healthy red blood cells) and preeclampsia Preeclampsia and Eclampsia Preeclampsia is new high blood pressure or worsening of existing high blood pressure that is accompanied by excess protein in the urine and that develops after the 20th week of pregnancy. Eclampsia... read more (high blood pressure and protein in the urine that can stress the fetus).

Infants born to younger adolescents (especially those under 15 years of age) are more likely to be born prematurely and to have a low birth weight. However, with proper prenatal care, older adolescents have no higher risk of pregnancy problems than adults from similar social and economic backgrounds.

All of the options may cause emotional stress. Counseling for both the girl and her partner can be very helpful. Counseling should also include education about use of contraception after the pregnancy.

An adolescent's parents may have different reactions when their child is pregnant or has impregnated someone. Emotions may range from distress to excitement, apathy, disappointment, or anger. It is important for parents to express their support and willingness to help the adolescent sort through their choices. Parents and adolescents need to communicate openly about abortion, adoption, and parenthood, which are all tough options for adolescents to struggle with alone.

NOTE: This is the Consumer Version. DOCTORS: CLICK HERE FOR THE PROFESSIONAL VERSION
CLICK HERE FOR THE PROFESSIONAL VERSION
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