New ACOG Guidelines on Teen Contraception

Guideline Watch |
August 14, 2017

New ACOG Guidelines on Teen Contraception

  1. Eleanor Bimla Schwarz, MD, MS

Recommendation: Subdermal implants and intrauterine contraception should be routinely offered to teens.

  1. Eleanor Bimla Schwarz, MD, MS

Sponsoring Organization: American College of Obstetricians and Gynecologists (ACOG)

Target Audience: Obstetricians/gynecologists and other clinicians who counsel adolescent patients

Background

Three quarters of adolescent pregnancies in the U.S. are unintended. Preventing undesired pregnancy requires effective contraceptive counseling and timely access to contraceptive services. To facilitate this, the ACOG Committee on Adolescent Health Care has identified five clinical best practices.

Key Points

  • Regardless of a patient's age or previous sexual activity, contraceptive needs, expectations, and concerns should routinely be assessed.

  • Discussions of contraception should begin with information on the safest and most effective methods: intrauterine devices and subdermal implants. As these methods typically provide greater satisfaction, higher efficacy, and higher continuation rates than short-acting contraceptives, they are excellent contraceptives for adolescents.

  • Emergency contraception should be routinely included in all discussions of contraceptive options, and clinicians should consider prescribing emergency contraception pills in advance.

  • Common misperceptions about contraceptives should be addressed in a way that is age-appropriate and compatible with the patient's health literacy.

  • During initial encounters and all follow-up visits, clinicians should also assess sexual concerns, behavior, relationships, prevention strategies, and testing and treatment for sexually transmitted infections per the Centers for Disease Control and Prevention's guidelines.

Comment

Although this committee opinion addresses obstetrician-gynecologists, the guidance is relevant to all clinicians caring for teens, including pediatricians, family physicians, advanced practice nurses, and physician assistants. While great progress has been made in recent years (NEJM JW Womens Health Oct 2016 and J Adolesc Health 2016; 59:577), continued efforts to provide teens with high-quality contraceptive care are needed, in light of low rates of long-acting contraceptive use among teens who use contraception and shrinking access to safe, legal abortion in the U.S.

Editor Disclosures at Time of Publication

  • Disclosures for Eleanor Bimla Schwarz, MD, MS at time of publication Grant / Research support Office of Adolescent Health Editorial boards Contraception; Journal of General Internal Medicine

Citation(s):

Reader Comments (1)

Paolo Zola Physician, Obstetrics/Gynecology, University of Turin Italy

Nice job
I believe that the IUD schould be more easy to do than implantation at least in my personal experience

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