Adolescent Contraception Use after Pregnancy, an Opportunity for Improvement

Haider, Sadia; Stoffel, Cynthia; Dude, Annie

doi:10.1016/j.jpag.2018.03.005

Cited by 6 publications

(4 citation statements)

References 35 publications

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Section: Introductionmentioning

confidence: 99%

“…5 Furthermore, approximately 50% of women report unprotected intercourse within 6 weeks postpartum. 6 The absence of effective contraception during this period of life puts women at risk for an unintended pregnancy 7 and it has been shown that 2.3% of women in Sweden have an abortion within 1-2 years of childbirth. 5 There is evidence that placement of a copper intrauterine device (Cu-IUD) or an IUD-intrauterine system (IUS) within hours after vaginal delivery is safe.…”

Section: Introductionmentioning

confidence: 99%

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Effectiveness, safety and overall satisfaction of early postpartum placement of hormonal IUD compared with standard procedure: An open‐label, randomized, multicenter study

Liljeblad

Kallner

Brynhildsen

2022

Acta Obstet Gynecol Scand

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Introduction In this open‐label, randomized controlled, non‐inferiority, multicenter study we aimed to study the risk of termination of pregnancy within 1 year postpartum, the safety profile and patient acceptability after early postpartum insertion of a hormonal intrauterine device (LNG‐IUS, Mirena®) compared with standard placement 6–8 weeks postpartum. Material and methods April 2018 to January 2020 women with uncomplicated vaginal delivery at four urban birth centers in Sweden, were randomized to either early placement within 48 h after delivery (early group) or standard placement 6–8 weeks postpartum (standard group) of a hormonal intrauterine device. The main outcome measure was the proportion of terminations of pregnancies in each group during the first year after placement of the intrauterine device. Registration EudraCT database no. 2017–001945‐29. Results The study was prematurely stopped according to the protocol due to an expulsion rate >20% in the early group. No pregnancies occurred. Fifty‐two women were randomized to early and 49 women to standard insertion. In the early group, 23/52 (44.2%) of the intrauterine devices were expelled. After expulsion, 10 women chose to have another hormonal intrauterine device placed but still significantly fewer women (39/52, 75%, p = 0.22) in the early group used the hormonal intrauterine device method at study completion. No expulsions occurred in the standard group, but 5/49 (10.2%) requested removal and 41/49 (83.7%, p = 0.22) had used the hormonal intrauterine device method continuously for 1 year. Conclusions Early hormonal intrauterine device insertion after vaginal delivery is associated with high expulsion rates. Despite this, a high continuation rate of the hormonal intrauterine device method is seen among women once choosing the method. In the light of high continuation rates, the advantages of early insertion could balance the risk of expulsion for well‐informed women.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Effectiveness, safety and overall satisfaction of early postpartum placement of hormonal IUD compared with standard procedure: An open‐label, randomized, multicenter study

Liljeblad

Kallner

Brynhildsen

2022

Acta Obstet Gynecol Scand

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“…Many of the factors related to adolescent mothers' first pregnancy, like education status, use of contraception, living situation, interpersonal relationships, social and financial resources, and receipt of public assistance are all associated with higher likelihood of a repeat pregnancy (Maravilla et al, 2017; Maynard & Rangarajan, 1994; Rowlands, 2010). Repeat pregnancies also imply continued risky sexual behaviors, which leave adolescent mothers vulnerable to sexually transmitted diseases (Haider et al, 2018; Herman et al, 2011; Meade & Ickovics, 2005) and are linked to pregnancy‐induced hypertension, anemia, and death (Asheer et al, 2014; Black et al, 2006; Coard et al, 2000; Honig & Morin, 2001; Raneri & Wiemann, 2007). Further, unintended repeat pregnancy makes it more difficult for these adolescents to complete their education and build economic stability (Kagawa et al, 2017; Mollborn & Jacobs, 2012; Polit & Kahn, 1986).…”

Section: Introductionmentioning

confidence: 99%

Parental support influencing the timing of repeat pregnancy for adolescent mothers

et al. 2023

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ObjectiveThis study examined the relationship between parental support and the timing of adolescent mothers' repeat pregnancies.BackgroundShort interpregnancy timing during adolescence, or an early repeat pregnancy, is a concerning outcome for adolescent mothers because they exacerbate the previous and ongoing adversities of adolescent mothers. Although social support tends to be positive for parenting and well‐being, it is unclear whether social support is protective for when adolescent mothers experience a repeat pregnancy. Parents are the primary source of support for adolescent mothers; thus, it is important to examine their influence on adolescent mothers' experience(s) of repeat pregnancy.MethodsSemi‐Markov multistate models were applied to 20 years of data to examine the relationship between support and timing and risk of subsequent pregnancies for 471 adolescent mothers in the National Longitudinal Study of Youth 1997.ResultsThis study found that emotional and financial support from parents predicts a higher likelihood of delayed repeat pregnancies, whereas informational support from parents predicts earlier repeat pregnancies for adolescent mothers.ConclusionThe effects of parental support are multifaceted and appear to differentially influence when adolescent mothers experience repeat pregnancies.ImplicationsUnderstanding how parental support influences when adolescent mothers experience repeat pregnancy can inform programs that aim to strengthen family support for pregnant and parenting youth.

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“…The magnitude of the risk of unintended pregnancy and possible subsequent abortion is not known. Young women seem to be the most vulnerable group for unintended pregnancy after childbirth [2,3]. Short interpregnancy intervals and unintended childbirth have been associated with a negative impact on maternal health [4,5] and a negative obstetric outcome [6].…”

Section: Introductionmentioning

confidence: 99%

Risk of abortion within 1–2 years after childbirth in relation to contraceptive choice: a retrospective cohort study

Liljeblad

Kallner

Brynhildsen

2020

The European Journal of Contraception & Reproductive Health

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Objectives: The primary objective of the study was to investigate whether the choice of long-acting reversible contraception (LARC) was associated with the risk of abortion over a period of 24 months postpartum. The secondary objective was to analyse whether other significant factors were affecting the risk of abortion during this period. Methods: In this retrospective cohort study, we analysed 11,066 women who had delivered in three Swedish cities during 2013 and 2014. Demographic and medical variables were obtained from medical records. Attendance at the postpartum visit, choice of postpartum contraception and history of abortion was noted. Logistic regression analysis was performed to assess factors associated with the risk of abortion. The main outcome measure was the proportion of women with abortion up to 24 months postpartum. Results: Data from 11,066 women were included in the final analysis. Within 12-24 months after delivery 2.5% of women had an abortion. The choice of LARC after childbirth reduced the risk of subsequent abortion (odds ratio 0.74; 95% confidence interval [CI] 0.60, 0.91; p ¼ .005). Smoking, age <25 years and have had a previous abortion significantly increased the risk of abortion during follow-up, whereas exclusive breastfeeding decreased the risk. Conclusions: Increasing the proportion of women who choose LARC postpartum could decrease the risk of abortion for up to 2 years after childbirth.

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Adolescent Contraception Use after Pregnancy, an Opportunity for Improvement

Cited by 6 publications

References 35 publications

Effectiveness, safety and overall satisfaction of early postpartum placement of hormonal IUD compared with standard procedure: An open‐label, randomized, multicenter study

Effectiveness, safety and overall satisfaction of early postpartum placement of hormonal IUD compared with standard procedure: An open‐label, randomized, multicenter study

Parental support influencing the timing of repeat pregnancy for adolescent mothers

Risk of abortion within 1–2 years after childbirth in relation to contraceptive choice: a retrospective cohort study

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