Expanding contraceptive services in EDs could reduce unintended adolescent pregnancies

Key takeaways:

• Among adolescents surveyed in EDs, 28.9% reported using no contraception.
• Few adolescents who were eligible for emergency contraception in EDs ultimately received it.

Introduction

More than one-quarter of sexually active adolescents who accessed care in emergency departments (EDs) reported not using contraception, increasing their risk for unintended pregnancy. This study emphasizes the importance of expanding contraceptive services in pediatric EDs to reduce the number of unintended adolescent pregnancies. The researchers highlight the need to provide preventive care services in the ED for marginalized populations, particularly teenagers.

Methods

The researchers conducted a secondary analysis of a large multicenter pragmatic trial that aimed to improve testing, detection, and treatment of sexually transmitted infections in adolescents. The trial implemented confidential, computerized sexual health screening through tablets at six pediatric EDs. The researchers analyzed data from 1,063 participants who answered questions about contraceptive use.

Results

Among the participants, 71.1% reported using contraception during their last sexual encounter. The most common methods used were short-acting hormonal methods (29.4%), male condoms (24.5%), and long-acting reversible contraception (15.4%). However, 28.9% reported not using any contraception. The annual pregnancy risk for the participants was calculated to be 7.89%. Although 10.2% of the cohort was eligible for emergency contraception, only 5.6% received it.

Discussion

The study findings highlight the high risk of pregnancy among adolescents accessing care in EDs. The researchers emphasize the need to embed sexual health service provision in all healthcare settings for adolescents, including EDs. They also emphasize the importance of reproductive justice and adolescent-centered approaches in addressing the sexual health needs of youth.

Conclusion

Expanding contraceptive services in pediatric EDs can help reduce the number of unintended adolescent pregnancies. It is crucial to identify opportunities to provide preventive care services in the ED for marginalized populations, particularly teenagers. Further research is needed to develop and test innovative ways to address the sexual health needs of youth.

References:

1. Canter H, et al. JAMA Netw Open. 2024;doi:10.1001/jamanetworkopen.2024.18213.
2. Gutman CK, et al. JAMA Netw Open. 2024;doi:10.1001/jamanetworkopen.2024.18194.

SDGs, Targets, and Indicators Analysis:

1. Which SDGs are addressed or connected to the issues highlighted in the article?

• SDG 3: Good Health and Well-being
• SDG 5: Gender Equality
• SDG 10: Reduced Inequalities
• SDG 17: Partnerships for the Goals

The article discusses the issue of unintended adolescent pregnancies and the need for expanding contraceptive services in pediatric emergency departments (EDs). This aligns with SDG 3, which aims to ensure healthy lives and promote well-being for all at all ages. It also relates to SDG 5, which focuses on achieving gender equality and empowering women and girls. Additionally, the article highlights the importance of identifying opportunities to provide preventive care services in the ED for marginalized populations, which is relevant to SDG 10 on reducing inequalities. Lastly, the mention of partnerships and collaboration to address the issue connects to SDG 17, which emphasizes the importance of partnerships for achieving sustainable development.

2. What specific targets under those SDGs can be identified based on the article’s content?

• Target 3.7: By 2030, ensure universal access to sexual and reproductive health-care services, including for family planning, information and education, and the integration of reproductive health into national strategies and programs.
• Target 5.6: Ensure universal access to sexual and reproductive health and reproductive rights as agreed in accordance with the Program of Action of the International Conference on Population and Development and the Beijing Platform for Action and the outcome documents of their review conferences.
• Target 10.2: By 2030, empower and promote the social, economic, and political inclusion of all, irrespective of age, sex, disability, race, ethnicity, origin, religion, or economic or other status.
• Target 17.17: Encourage and promote effective public, public-private, and civil society partnerships, building on the experience and resourcing strategies of partnerships.

Based on the article’s content, the specific targets identified are related to ensuring universal access to sexual and reproductive health-care services (Target 3.7) and sexual and reproductive rights (Target 5.6). The need to provide preventive care services in the ED for marginalized populations aligns with the target of promoting social, economic, and political inclusion (Target 10.2). Lastly, the mention of identifying opportunities and partnerships emphasizes the importance of effective collaborations (Target 17.17).

3. Are there any indicators mentioned or implied in the article that can be used to measure progress towards the identified targets?

• Contraception use rate among sexually active adolescents in EDs
• Proportion of eligible adolescents in EDs who receive emergency contraception
• Annual pregnancy risk among adolescents accessing care in EDs
• Availability and accessibility of contraceptive services in pediatric EDs

The article mentions several indicators that can be used to measure progress towards the identified targets. These include the contraception use rate among sexually active adolescents in EDs, the proportion of eligible adolescents who receive emergency contraception, the annual pregnancy risk among adolescents accessing care in EDs, and the availability and accessibility of contraceptive services in pediatric EDs.

SDGs, Targets, and Indicators Table:

Source: healio.com