Most teenagers who become pregnant have sought advice about contraception in the previous year, a study has found. Supply of emergency contraception was also linked with an increased rate of termination.
The study was based on an analysis of case notes of 240 patients in general practice with a recorded conception before the age of 20. The group was compared with 719 control patients who did not have a teenage pregnancy. Dr Dick Churchill (clinical lecturer, University of Nottingham medical school) and colleagues found that 93 per cent of cases and 84 per cent of controls had had at least one consultation with a health professional in general practice in the year before conception. Cases were likely to consult more frequently and for both contraceptive and non-contraceptive reasons.
In terms of contraception alone, 71 per cent of cases had consulted for contraception compared with 47 per cent of controls. The contraceptive pill had been prescribed for 65 per cent of cases and 42 per cent of controls. Cases were more likely to have been given injectable progestogens or condoms than controls, the authors say.
Overall, 22 per cent of pregnant teenagers had terminations. Of this group, cases were significantly more likely to have been provided with emergency contraception than controls (21 and 8 per cent respectively). In addition, 51 per cent of the termination group had been prescribed an oral contraceptive compared with 69 per cent of cases who had not had a termination.
The authors say that teenagers who choose emergency contraception may be at higher risk of unintended pregnancy than those who do not and that it may be an indicator of "risk taking in sexual activity". They stress the importance of follow-up after consultation for emergency contraception and caution that the study "raises questions about the possible supply of emergency contraception by agencies who are unable to provide such follow-up."
They conclude that the study revealed that teenage fears about confidentiality and embarrassment are less of a barrier when seeking contraceptive advice than previously supposed (British Medical Journal 2000;321:486).