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Press Releases : 2015 Press Releases

Barriers to Contraceptive Access for Adolescents Leads to High U.S. Adolescent Pregnancy Rates

Thursday, July 16, 2015  
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Barriers to Contraceptive Access for Adolescents Leads to High U.S. Adolescent Pregnancy Rates

— Leading Nursing Journal Explores Health Care Practices in Providing Contraceptives

to Young Women —


Washington, DC –July 16, 2015– Adolescents and young women under the age of 25 have the highest rates of unplanned pregnancy. Factors that have been associated with this trend include a lack of knowledge among adolescents about contraceptives and their use, as well as a fear of undergoing a pelvic exam and Pap screening in order to obtain contraception.


Two articles published in the June/July 2015 issue of Nursing for Women’ Health, the clinical practice journal of the Association of Women’s Health, Obstetric and Neonatal Nurses (AWHONN), explore two barriers adolescents experience in accessing contraceptives. First, adolescents lack knowledge about the effectiveness and ease-of-use benefits of long-acting reversible contraception (LARC) compared to other birth control methods. LARC is the first-line contraceptive recommendation for adolescents because of its effectiveness, high rates of satisfaction and continuation, and no need for daily adherence. Second, adolescents many be fearful of undergoing a Pap screen in order to obtain contraceptives. This fear is not unfounded as health care workers may lack awareness about current guidelines for Pap screening in adolescents, which can lead to unnecessary pelvic exams for young women seeking contraception.


In “Long-Acting Reversible Contraception for Adolescents,” Holly B. Fontenot, PhD, RN, WHNP-BC, and Heidi Collins Fantasia, PhD, RN, WHNP-BC, reviewed studies that examined the perspectives of health care providers and adolescents and young women regarding LARC use. Both groups rate the top benefit of LARC use as not having to remember to use the contraception. Additionally, only 32% of healthcare providers who care for adolescents reported providing implants of intrauterine devices (IUDs) for their patient. Higher rates were found among those providers who had obtained additional women’s health training.


“Despite national recommendations for an increase use of LARC, barriers continue to exist,” wrote the authors. “There are some disconnects to patient and provider perspectives on the advantages and disadvantages of LARC use, which could lead to less effective contraceptive counseling.”


Elizabeth  abzdyl, CNM, DNP, APN; Janet L. Engstrom, PhD, APN, CNM, WHNP-BC; and Barbara L. McFarlin, PhD,  NM, RDMS, FACNM, studied a quality improvement project in “Health Care Workers’ Beliefs and Practices Around Pap Screening for Adolescents Seeking Contraception.” Before and after a 20-minute educational program about evidence-based recommendations for Pap screening before providing contraception, the researchers measured frequency of Pap screen examinations along with attitudes and beliefs about screening. They found a modest decrease in the number of adolescents required to undergo Pap screening to start or continue contraception. The authors recommended developing clinic policies to require adherence to best-practice guidelines on screening and suggested that reimbursement structures can be changed to reduce unnecessary procedures.


“The reluctance of health care workers to change Pap screening practices demonstrates the need for better methods of translating evidence-based Pap screening guidelines to practice, with the goal of all women receiving consistent health care based on the most current evidence, not on other factors such as provider opinion or preference,” wrote the authors.


“Adolescents benefit greatly from personalized contraceptive counseling from trained health care providers, especially to address their concerns or fears,” said AWHONN’s CEO, Lynn Erdman, MN, RN, FAAN. “If we hope to reduce unintended pregnancies and support young women’s health, we must remove unnecessary barriers to accessing contraception.”


For media interviews, contact:

Kelly Mack for AWHONN




About Nursing for Women's Health

Nursing for Women's Health is a bimonthly refereed clinical practice journal of the Association of Women's Health, Obstetric and Neonatal Nurses. The journal circulates to more than 25,000 nurses   Who care for women and newborns and is available online at



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