Characteristics of long-acting reversible contraception users presenting to a pediatric emergency department

Abstract

BACKGROUND: One in ten sexually active adolescents in the United States become pregnant each year. Significant differences in unintended pregnancy and use of long-acting reversible contraceptive (LARC) methods: the sub-dermal implant, the copper intrauterine device (IUD) and hormonal IUDs, exist between socioeconomic strata as well as ethnic and racial groups. Women using LARC are 20 times less likely to experience a pregnancy than women using short-acting reversible methods. Thus, LARCs present a major opportunity for the prevention of unintended pregnancy. PURPOSE: Characterize contraceptive use, demographics, and behavioral characteristics of a novel population: young women presenting to an urban Pediatric Emergency Department (PED) in order to better understand the contraceptive needs of this population. METHODS: We characterized the current LARC usage. Using an anonymous paper-based questionnaire, we surveyed women ages 16-21 years regardless of chief complaint presenting to our PED regarding their demographics, health care access, sexual history, and history of contraceptive use. We conducted a cross-sectional analysis of demographic characteristics for current LARC and non-LARC users (n=331) using chi-squared for categorical variables and student's t-test for continuous variables. RESULTS: No significant differences were found between women currently using LARC and those not using LARC, however current LARC usage in our population was 15.8%, about three times that documented in the most recent national studies conducted in 2013. CONCLUSION: Current LARC use is particularly high in our urban PED setting. More research is necessary to determine if this is part of a larger national trend or if the early implementation of no-cost contraception in Massachusetts and changes in provider or patient attitudes towards LARC may explain the large observed difference in LARC usage.