Adolescents and emergency contraception (original) (raw)

2002, Journal of Pediatric Health Care

The United States continues to experience an unacceptably high rate of teenage pregnancies, especially when compared with other industrialized nations (Singh & Darroch, 2000). Although the rate of teen pregnancy in the United States has been decreasing for the past few years (Kahn, Brindis & Glei, 1999; Kann et al., 2000), it is still very high, notably among Black and Hispanic teens (Donovan, 1998). In the 1999 Youth Risk Behavior Survey, nationwide, half of all high school students reported having had sexual intercourse, and 6.3% of high school students reported that they had become pregnant or gotten their partner pregnant (Kann et al., 2000). Other statistics suggest that each year, almost 1 million teenage women, that is, 11% of all young women aged 15 to 19 years, become pregnant (Alan Guttmacher Institute [AGI], 1998). Between 78% and 85% of teen pregnancies are unplanned (AGI, 1998). Although somewhat fewer teens are having sex (Donovan, 1998) the primary explanation for the decrease in the teen pregnancy rate is believed to be increased contraceptive use (Kahn et al., 1999). However, teenagers are less likely than older women to practice contraception without interruption over the course of a year and are more likely to practice contraception sporadically (Glei, 1999). In addition, contraceptive failure rates are high. Estimates are that close to 50% of unintended pregnancies are the result of contraceptive failure (Chiou, Shrier, & Emans, 1998). Contraceptive failure rates appear to be higher for teens from poor homes (less than 200% of the federal poverty rate) than for teens whose family incomes were higher (Kahn et al., 1999). Of note, a study of 147 teens who experienced an unplanned pregnancy found that 80% had used contraception at the time of conception, and 80% of these young women could explain why their method failed (Chiou et al., 1998). Mathematical estimates suggest that the commonly used Yuzpe method of emergency contraception (EC), described below, results in a 75% reduction in pregnancies. Therefore, if these young P H C