Enitan Adegite, MD, MPH
Associate Professor, Pediatrics
Abstract:
Goals
Increasing access to Long‐Acting Reversible Contraception (Larc) at The Teen and Young Adult Center by provision of
(i)Intrauterine Devices on Site and
(ii)Identifying barriers and opportuniƟes to improve access to Nexplanon
Background
Teen pregnancy although on the decline continues to be an ongoing challenge in the USA1. Teen Pregnancy is associated with negative outcomes such as higher risks of eclampsia, puerperal endometritis, and systemic infections, and babies of adolescent mothers face higher risks of low birth weight, preterm birth, and severe neonatal conditions2. Adolescents have the highest rates of unintended pregnancies. 75% of pregnancies in teens ages 15‐19yo are unintended3. Hispanic, non‐Hispanic black and American Indian/Alaska Native teens have the highest rates of teen births in the USA4. Access to effective contraception is one of the strategies to reduce teen pregnancy. LARC methods are less user dependent, and therefore have lower failure rates, so are recommended as first line when contraceptives are being offered. Their use is also associated with increased initiation and continuation of birth control. These Larcs include progestin containing intrauterine systems, Copper intrauterine device and etonogestrel subdermal implant ‐Nexplanon®. These Larcs can be used for 3‐16 years depending on type. Intrauterine systems and devices also have the added advantage of being effective forms of emergency contraception.
Services are provided to all patients irrespective of insurance status i.e., if they do or do not have health insurance. The overarching mission of the TYAC is to equip teens and young adults with the tools necessary to make well‐informed decisions regarding their sexual and reproductive health, increase knowledge of and access to services offered, and to create safe spaces for teens and young adults to find support and resources to foster positive life outcomes. Developmentally appropriate, medically accurate, confidential, and comprehensive sexuality education that includes information on abstinence as well as the full range of FDA‐approved contraceptives are offered free or low‐cost at the TYAC. Fertility awareness‐based methods (FABMs), reproductive life plan education, condoms and condom negotiation skill counseling, sexually transmitted infection (STI) screening and treatment, a variety of oral contraceptive pills, the vaginal ring, Nexplanon include the broad range of services that are being offered.