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Committee Opinion No. 699: Adolescent Pregnancy, Contraception, and Sexual Activity

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doi: 10.1097/AOG.0000000000002041
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Abstract

Recommendations and Conclusions

The American College of Obstetricians and Gynecologists (the College) makes the following recommendations and conclusions:

  • In 2015, the birth rate among U.S. adolescents and young adults (aged 15–19 years) reached a historic low. Pregnancy in adolescents has decreased largely because adolescents are becoming more effective contraceptive users.
  • A reproductive justice framework for contraceptive counseling and access is essential to providing equitable health care, accessing and having coverage for contraceptive methods, and resisting potential coercion by health care providers.
  • The College supports access for adolescents and young adults to all contraceptive methods approved by the U.S. Food and Drug Administration (FDA).
  • Because of the safety and effectiveness of long-acting reversible contraceptive (LARC) methods, the College and the American Academy of Pediatrics (AAP) endorse the use of intrauterine devices (IUDs) and implants as contraceptive options for adolescents.
  • The College, the Centers for Disease Control and Prevention (CDC), and AAP also recommend that LARC methods be discussed with pregnant adolescents.
  • For adolescents who choose a LARC method, initiation should be offered immediately after delivery, pregnancy loss, or abortion.
  • Where allowed, obstetrician–gynecologists should provide adolescents the opportunity to discuss their reproductive goals and contraceptive needs without a parent or guardian present for at least part of the visit.
  • The College supports the use of evidence-based, medically accurate, age-appropriate sexuality education as an integral part of health education.
  • Dual method use—pairing condoms with more effective contraceptive methods to protect against sexually transmitted infections (STIs) and unwanted pregnancy—is the ideal contraceptive practice for adolescents.

© 2017 by The American College of Obstetricians and Gynecologists. Published by Wolters Kluwer Health, Inc. All rights reserved.