Majority of unplanned adolescent pregnancies result from lack of contraception

  • J Pediatr Adolesc Gynecol

  • von Elisabeth Aron, MD, MPH, FACOG
  • Clinical Essentials
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Takeaway

  • The majority of unplanned adolescent pregnancies result from lack of contraception.

Why this matters

  • 50% of unintended pregnancies occur in adolescent women worldwide.
  • Many of these unintended adolescent pregnancies end in unsafe abortions; adolescents are more likely to pursue abortions from untrained providers or to have a self-induced abortion compared with older women.

Key results

  • 72.2% used no contraception within the last 5 years.
  • Of those using contraception, pregnancy occurred because of failure of:
    • Traditional methods: 5.1%; 
    • Short-acting modern methods: 7.2%; and
    • Long-acting modern methods: 0.1%.
  • For those who discontinued medications at any time in the last 5 years:
    • 2% discontinued traditional methods,
    • 13.2% discontinued short-acting modern methods, and
    • 0.4% discontinued long-acting modern methods.
  • Reasons for discontinuation included failure, side effects, health concerns.
  • Living in a rural area (P<.05 and no education were associated with contraception nonuse.>

Study design

  • Cohort taken from the Demographic and Health Survey program, a representative household survey carried out in over 90 low- and middle-income countries since 1984.
  • Women between ages 15 and 19 years with an unintended pregnancy were identified (n=2173).
  • Reasons for discontinuing contraception were abstracted.
  • Funding: None.

Limitations

  • Not all reasons for discontinuation captured.