J Pediatr Adolesc Gynecol. 2016 Nov 18.

Motivational interviewing to promote long-acting reversible contraception in postpartum teenagers

Tomlin K, Bambulas T, Sutton M, Pazdernik V and Coonrod DV

Abstract

Study objective: To determine if teenage patients receiving prenatal care in an adolescent-focused clinic, emphasizing Long-acting Reversible Contraception (LARC) using motivational interviewing techniques, had higher rates of uptake of postpartum LARC than a control group.

Design: Retrospective cohort study comparing young women who received prenatal care in an adolescent-focused setting and those enrolled in Standard Prenatal Care.

Participants: Adolescents between the ages of 13 and 17 receiving prenatal care within the Maricopa Integrated Health safety-net system between 2007 and 2014.

Intervention: Motivational interviewing within the context of adolescent-focused prenatal care.

Outcome measures: Rates of uptake of LARC within 13 postpartum weeks.

Results: The adjusted rate of LARC for adolescent-focused prenatal care participants by 13 weeks postpartum is 38% (95% CI, [29%-47%]) compared to 18% (95% CI, [11%-28%]) for Standard Care participants, with an adjusted OR of LARC use of 2.8 (95% CI, [1.5-5.2]). Amongst patients who received adolescent-focused prenatal care, the majority (27% versus 12.7%) were using an IUD as opposed to implantable contraceptive device.

Conclusion: Participation in an adolescent-focused antepartum setting using motivational interviewing to emphasize postpartum LARC resulted in nearly 3 times higher rates of uptake as compared to standard prenatal care.

Comment: This paper links nicely with the previous abstract: telling teenagers and adolescents what to do, is usually not overly successful. However, when we have a motivational interview with pregnant adolescents, which requires a lot of listening on our side!, they become convinced and motivated themselves to use a good contraceptive immediately after birth. (HMV)