AAP: Pediatricians should educate adolescents on all forms of contraception

The AAP’s Committee on Adolescence provides updated recommendations on contraception for adolescents in a policy statement recently published in Pediatrics.

Approximately 750,000 adolescents become pregnant each year, according to the committee. More than 80% of these pregnancies are unplanned, indicating a need for effective contraception among adolescents.

The policy statement updates the 2007 statement and emphasizes pediatricians’ role in their patients’ lives. The long-term relationships pediatricians have with patients and their families may allow them to openly discuss sensitive topics such as sexuality and relationships and promote healthy sexual decisions.

An accompanying technical report summarizes contraceptive options for adolescents, their effectiveness, and how pediatricians should counsel patients on each of them.

According to the AAP, pediatricians should:

Counsel adolescent patients on and ensure access to a wide range of contraceptive services;
Be capable of educating adolescent patients about long-acting reversible contraception methods, ie, implants and intrauterine devices (IUDs). These methods should be considered first-line contraceptive choices;
Continue to ensure adolescent access to depot medroxyprogesterone acetate and the contraceptive patch, as they are highly effective contraceptive methods;
Allow adolescents to consent to contraceptive care and protect their consent;
Be aware that pelvic examination is not needed before prescribing contraceptives, referring for IUD placement, or screening for STIs;
Encourage consistent and correct use of condoms during every sexual intercourse act;
Have a working knowledge of different combined hormonal methods an regimens because they can be used contraception or management of common conditions including acne, dysmenorrhea, and heavy menstrual bleeding;
Remember that adolescents with chronic illnesses have similar contraceptive needs to healthy adolescents, though illness may complicate contraceptive choices;
Regularly update patients’ sexual histories and provide a confidential, nonjudgmental setting where contraception, STI screening, and sexual risk reduction can be discussed with patients who choose to not be abstinent;
Use a developmentally appropriate, patient-centered approach to address contraceptive needs; and
Utilize the abilities and resources of the pediatric office to become educated on state or federally subsidized insurance programs and clinics that provide free or low-cost reproductive health care, services and supplies.

“A working knowledge of contraception will assist the pediatrician in both sexual health promotion and treatment of common adolescent gynecologic problems,” the committee wrote.

For more information:

Committee on Adolescence. Pediatrics. 2014;doi:10.1542/peds.2014-2299.

Ott MA. Pediatrics. 2014;doi:10.1542/peds.2014-2300.

Disclosure: The researchers report no relevant financial disclosures.