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Etonogestrel-releasing subdermal contraceptive implant for adolescents in the postpartum period: a randomized controlled trial

Amy Bryant, University of North Carolina–Chapel Hill, 2012

Project abstract

In the United States, 82% of all adolescent pregnancies are unintended. Additionally, many adolescents who give birth experience repeat pregnancy within two years. Providing long-term contraception immediately postpartum may be the single most important factor for decreasing rapid repeat pregnancy. In the adolescent population, as up 47% of adolescents will resume sexual intercourse within 6 weeks of a birth, and many adolescents do not return for a postpartum visit.

The etonogestrel-releasing contraceptive implant is a long-acting reversible contraceptive that is acceptable to adolescents, easy to place whether vaginal or cesarean delivery occurs, and highly effective at reducing unintended pregnancy. The overall objective of this study is to compare the use of the etonogestrel implant at one year postpartum among adolescents who receive the implant either immediately postpartum or at the traditional postpartum visit. We hypothesize that adolescents who receive the implant before leaving the hospital after delivery will be more likely to be using a long-acting contraceptive at one year postpartum than adolescents who receive the contraceptive implant at 6 weeks postpartum.

A total of 96 adolescents ages 14-20 will be enrolled, with 48 randomized to each of the two groups. Participants will be followed up at 3, 6, 9 and 12 months postpartum. The primary outcome is the use of the contraceptive implant at one year postpartum.

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