Adolescent Contraception Use after Pregnancy, an Opportunity for Improvement.

STUDY OBJECTIVE: To describe contraceptive method use by adolescent women in the 6 months after any pregnancy. DESIGN: We conducted a secondary analysis of the 2011-2013 and 2013-2015 cycles of the National Survey of Family Growth. SETTING: This survey is a nationally-representative population-based survey of reproductive aged women in the United States. PARTICIPANTS: The sample included respondents who had at least 1 pregnancy that ended within the contraceptive calendar period as well as before the month of the respondent's 20th birthday. Women were included even if they did not have a full 6 months' worth of data. INTERVENTIONS AND MAIN OUTCOME MEASURES: We examined contraception method use at 1, 2, 4, and 6 months post pregnancy regardless of pregnancy outcome (live birth, induced abortion, or miscarriage). RESULTS: Our sample consisted of 337 women with a mean age of 18.5 years. Almost half (N = 158, weighted percentage = 43.5%) of adolescents were using no method of contraception at 1 month post pregnancy. By 6 months post pregnancy, only 143 of 287 women with data through 6 months (weighted percentage = 49.7%) were using more effective methods of contraception (long-acting reversible contraception or hormonal methods), and 83 of these 287 were using no method (weighted percentage = 29.2%), including 61 of 261 women who reported that their last pregnancy was unwanted. Women from racial and ethnic minorities were less likely to use the most effective contraceptive methods. Rapid repeat pregnancy occurred among 44 of 209 women in the subsample with 18 months' follow-up data (weighted percentage = 16.9%). Only 56 of 337 adolescents (weighted percentage = 19.0%) used long-acting reversible contraceptive methods at any time post pregnancy regardless of pregnancy outcome. CONCLUSION: Contraceptive use, especially of the most effective methods, remains low for adolescent women by 6 months post pregnancy.