Contraception and adolescents: ACOG releases counseling recommendations for clinicians

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Clinicians should routinely address the patient’s contraceptive needs, expectations, and concerns regardless of her age or previous sexual activity.
Clinicians should routinely address the patient’s contraceptive needs, expectations, and concerns regardless of her age or previous sexual activity.

The American College of Obstetricians and Gynecologists (ACOG) has released recommendations to help obstetrician-gynecologists counsel adolescents about using contraception. ACOG notes that clinicians should routinely address a patient's contraceptive needs, expectations, and concerns regardless of her age or previous sexual activity.

ACOG's Committee on Adolescent Health Care recommends that obstetrician-gynecologists work with their office staff to establish office procedures and routines that protect the privacy of adolescent patients whenever possible.

“Ideally, the initial reproductive health visit should take place between 13 years and 15 years and should encompass a discussion about contraception and STIs in addition to preventive medicine services such as human papillomavirus vaccination,” the committee notes.

“Sexual activity is not required before the discussion or offering of contraceptives,” the committee adds. “An adolescent-friendly environment is important, as is adequate time for the adolescent patient who may need additional explanation and details compared with an adult patient.”

ACOG makes the following recommendations:

  • Routinely address contraceptive needs, expectations, and concerns, regardless of age or previous sexual activity.
  • Be aware of the statutes on the rights of minors to consent to healthcare services, as these regulations vary by state.
  • Emergency contraception should be included in discussions about contraception. ACOG recommends that obstetrician-gynecologists write advance prescriptions for oral emergency contraception for their patients.
  • Long-acting reversible contraceptive methods are safe and excellent choices for adolescents, due to their higher efficacy, higher continuation rates, and higher satisfaction rates compared with short-acting contraceptives.
  • Obstetrician-gynecologists should begin discussions about contraception with information on the most effective methods first.
  • Obstetrician-gynecologists should be prepared to address the most common misperceptions about contraception in a way that is age appropriate and compatible with the patient's health literacy.
  • According to guidelines from the CDC, the initial discussion and future follow-up visits should include reassessment of sexual concerns, behavior, relationships, prevention strategies, and testing and treatment for sexually transmitted diseases.

Reference

  1. American College of Obstetricians and Gynecologists' Committee on Adolescent Health Care. Committee Opinion No. 710: Counseling adolescents about contraception. Obstet Gynecol. 2017;130(2):74-80. doi: 10.1097/AOG.0000000000002234
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