Contraception for adolescents after abortion

ABSTRACT

Introduction Preventing repeated unplanned pregnancy among adolescents is still a challenge because many of them fail to use effective contraception after abortion.

Objective To review currently recommended options of methods and counselling for effective prevention of repeat pregnancies in adolescents.

Methods Review of the literature that was identified through the Medline, ScienceDirect, Google and Popline databases and relevant expert opinions.

Results Counselling needs to be adapted to the needs, values and lifestyle of adolescents. The best results are achieved with nondirective or active contraceptive counselling, followed by regular check-ups and cautious and attentive approach in the management of doubts, prejudices and side effects related to the contraceptive chosen. Adolescents should initiate contraception immediately after abortion: the motivation for choosing an efficacious method is highest at that time; resumption of ovulation following induced abortion occurs on average after three weeks; more than half of these girls will resume sexual activity within two weeks after pregnancy termination. Long-acting reversible contraception use during adolescence is safe and most effective. However, achieving a high long-term continuation rate is especially challenging in adolescents; this is due to developmental and environmental characteristics that influence their contraceptive behaviour.

Conclusion Adolescents should immediately after abortion initiate a reliable contraceptive method, preferably one whose efficacy is not user-dependent. Providing an appropriate health care would contribute to achieving continuity in the prevention of repeat pregnancy.

Abstract

摘要 前言 预防青少年的重复非意愿妊娠一直是个挑战。因为流产后她们中的很多人未使用有效的避孕方法。

目的 回顾目前有效的防止青少年重复妊娠所推荐的选择方法和建议。

方法 回顾分析从Medline, ScienceDirect,Google及Popline数据库中查询的文献及相关专家意见。

结果 咨询需要适合青少年的需要、价值观和生活方式。最好能获得非直接的或积极的避孕咨询及随后的定期检查和用谨慎细心的方法管理有关避孕选择中遇到的疑问、偏见和副作用。青少年在流产后应立即避孕：当时选择有效方法的积极性最高；人工流产后恢复排卵的平均时间是3周；而在这些女孩中流产后有超过一半的在两周内恢复性行为。青少年使用长效可逆的避孕方法是安全和有效的。然而，青少年获得高的长期的续用率是非常困难的；这是因为发育和环境的特点影响了她们的避孕行为。

结论 青少年流产后应立即采用可靠的避孕方法，最好这种方法的有效性不取决于使用者。提供合适的医疗保健有助于实现防止重复妊娠的持续性。

KEYWORDS:

• Adolescent pregnancy
• Induced abortion
• Adolescent girls
• Contraception after abortion

ACKNOWLEDGEMENTS

The authors are very grateful to Prof. em. Jean-Jacques Amy for having critically reviewed the manuscript.

Declaration of interest

The authors report no conflict of interest. The authors alone are responsible for the content and the writing of the paper.