The Adolescent Center, Adolescent Medicine, Kaiser Permanente Washington, Bellevue, Washington.
Eating Disorder Assessment and Treatment Program, Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; Perelman School of Medicine at The University of Pennsylvania, Philadelphia, Pennsylvania; The PolicyLab at the Roberts Center for Pediatric Research, Philadelphia, Pennsylvania.
J Pediatr Adolesc Gynecol. 2021 Aug;34(4):484-490. doi: 10.1016/j.jpag.2020.12.008. Epub 2020 Dec 15.
The low rates of actual contraceptive failure and high rates of contraceptive use among young women highlight that choice of contraceptive method and patterns of contraceptive use greatly influence unintended pregnancy risk. Promoting contraceptive use among adolescent and young adult women requires supportive health systems and health providers who understand this population's evolving developmental needs. It also requires an awareness of effective tools for counseling patients, while being mindful of the power dynamics operational during clinical encounters to avoid inadvertently coercive interpersonal dynamics. Missed opportunities to provide such patient-centered care can lead to unplanned pregnancies and suboptimal health and social consequences for young women. Unfortunately, health providers often lack the tools and resources to appropriately identify and meet individual young women's contraceptive needs. This article summarizes the evidence supporting contraceptive counseling strategies linked with contraceptive initiation among young women, and evidence-based approaches for supporting contraceptive adherence and continuation after method initiation. It also orients readers to the unique neurodevelopmental factors that influence the shared decision-making process during contraception counseling sessions with young women. New and emerging approaches for supporting contraceptive initiation, adherence, and continuation are reviewed.
年轻女性实际避孕失败率低而避孕使用率高，这突出表明避孕方法的选择和避孕模式对意外怀孕风险有重大影响。要想促进青少年和年轻成年女性使用避孕措施，就需要有支持性的卫生系统和了解该人群不断发展的需求的卫生提供者。这还需要认识到为患者提供咨询的有效工具，同时要注意临床接触期间运作的权力动态，以避免无意中产生强制性的人际动态。错过提供这种以患者为中心的护理的机会可能导致年轻女性意外怀孕和健康及社会后果不佳。不幸的是，卫生提供者通常缺乏适当识别和满足个别年轻女性避孕需求的工具和资源。本文总结了支持年轻女性开始使用避孕措施的避孕咨询策略的证据，以及支持方法启动后坚持和继续使用避孕措施的循证方法。它还使读者了解影响与年轻女性进行避孕咨询时共同决策过程的独特神经发育因素。本文还回顾了支持避孕措施启动、坚持和持续使用的新出现方法。
