Removing Barriers to Contraceptive Access for Adolescents

Abstract

Contraception for AdolescentsAdolescence is the phase of life between childhood and adulthood, from ages 10 to 19 years.It is a unique stage of development and an important time for setting the foundations of good health. 1For post-menarchal adolescents, birth control is essential health care for both contraceptive and noncontraceptive purposes.According to United States nationally representative data, 40.5% of female teenagers, aged 15 to 19 years, are sexually active and of those, 52% had at some point used a birth control pill, 18% an injectable contraceptive agent, and 19% a long-acting reversible contraceptive (LARC). 2 Globally, there were 42 births per 1000 to girls aged 15 to 19 years in 2021. 3There are significant health risks associated with unintended pregnancy in adolescence, including prematurity, preeclampsia, and higher prevalence of cesarean deliveries 4 along with poor well-being outcomes such as poverty, low educational attainment, and poorer quality of life. 5These later consequences can be substantial for the adolescent, the family, the community, and society at large.Encouragingly, there has been a steady decline in adolescent pregnancy and abortion rates in the United States since the 1990s that can largely be attributed to expanded contraceptive use. 6For adolescents, hormonal contraceptives have potential benefits beyond preventing pregnancy such as treating dysmenorrhea, heavy or irregular menstrual bleeding, ovarian cysts, or acne.Up to 94% of adolescent females experience painful periods, 7 and up to 25% experience marked menstrual disturbances. 8Not surprisingly, adolescent females are more likely to use hormonal contraception to treat these conditions than older women, and it is estimated that a third of adolescents are prescribed birth control pills for noncontraceptive reasons.

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