Obstet Gynecol. 2017 Aug;130(2):e74-e80. doi: 10.1097/AOG.0000000000002234.
Modern contraceptives are very effective when used correctly and, thus, effective counseling regarding contraceptive options and provision of resources to increase access are key components of adolescent health care. Regardless of a patient's age or previous sexual activity, the obstetrician-gynecologist routinely should address her contraceptive needs, expectations, and concerns. Obstetrician-gynecologists should be aware of and be prepared to address the most common misperceptions about contraceptive methods in a way that is age appropriate and compatible with the patient's health literacy. The American College of Obstetricians and Gynecologists recommends that discussions about contraception begin with information on the most effective methods first. Emergency contraception routinely should be included in discussions about contraception, including access issues. Moreover, the American College of Obstetricians and Gynecologists recommends that obstetrician-gynecologists work with their office staff to establish office procedures and routines that safeguard the privacy of adolescent patients whenever possible. Adolescents' right of refusal for initiating or discontinuing a method should be addressed by obstetrician-gynecologists. At no time should an adolescent patient be forced to use a method chosen by someone other than herself, including a parent, guardian, partner, or health care provider. The initial encounter and follow-up visits should include continual reassessment of sexual concerns, behavior, relationships, prevention strategies, and testing and treatment for sexually transmitted infections per the Centers for Disease Control and Prevention's guidelines.
现代避孕药具在正确使用时非常有效，因此，就避孕选择提供有效的咨询以及提供资源以增加获取途径是青少年医疗保健的关键组成部分。无论患者年龄或既往性活动情况如何，妇产科医生都应常规关注其避孕需求、期望和担忧。妇产科医生应了解并准备好以适合年龄且与患者健康素养相匹配的方式，处理关于避孕方法最常见的误解。美国妇产科医师学会建议，关于避孕的讨论应首先从介绍最有效的方法开始。紧急避孕通常应纳入避孕讨论，包括获取途径问题。此外，美国妇产科医师学会建议，妇产科医生应与办公室工作人员合作，尽可能建立保护青少年患者隐私的办公室程序和常规。妇产科医生应处理青少年拒绝开始或停止使用某种方法的权利问题。任何时候都不应强迫青少年患者使用他人（包括父母、监护人、伴侣或医疗保健提供者）选择的方法。初次就诊和随访应包括持续重新评估性方面的担忧、行为、关系、预防策略，以及按照疾病控制与预防中心的指南进行性传播感染的检测和治疗。
