Postpartum Contraceptive Decision-Making of Parous Teens-A Qualitative Study.

STUDY OBJECTIVE

Approximately 25% of teens in the United States will become pregnant before the age of 18, and within 2 years, more than 31% will have a repeat pregnancy. Acknowledging that some adolescents might seek or be ambivalent toward rapid repeat pregnancy, compared with their counterparts, not using a long-acting reversible contraception method increases a teen's risk of another pregnancy in 2 years by more than 35 times. We seek to better understand the influences and factors surrounding adolescent postpartum contraceptive decision-making following the index delivery.

DESIGN

We completed a qualitative study via focused, semistructured interviews during an inpatient postpartum course. The interview guide was modeled after those used in other studies of adolescent contraceptive decision-making, beta tested, and developed iteratively. Interviews were completed, transcribed, coded, and analyzed with the assistance of Dedoose.

SETTING

The study was conducted at MetroHealth Medical Center in Cleveland, Ohio.

PARTICIPANTS

Parous adolescents aged 13-19 RESULTS: We performed 12 interviews prior to reaching theoretical saturation. Themes were identified related to the participants' prior experiences with contraception and prior and current pregnancies. The participants' contraceptive choices were influenced by personal relationships, varying levels of autonomy, misperceptions, and changing contraceptive needs.

CONCLUSIONS

We found that adolescents' contraceptive decision-making was influenced by their social networks and community, including their parents and friends. Mothers played a key role as adolescents transitioned to gaining more autonomy over their reproductive decisions. Providers should consistently present adolescents with comprehensive contraceptive options as a component of preventive health care.