Practices and Perceptions among Pediatricians regarding Adolescent Contraception with Emphasis on Intrauterine Contraception

Study Objective: This study was conducted to characterize pediatricians' current practice patterns and perceived barriers related to adolescent contraception counseling with an emphasis on intrauterine contraception (IUC). Design: We performed a mailed survey study to 400 general pediatricians. Setting: Surveys were mailed to pediatricians at their individual office locations. Participants: General pediatricians belonging to the Massachusetts Pediatric Society were included in the study. Interventions: The survey instrument assessed current practice patterns and perspectives as related to contraception counseling for adolescents. Main Outcome Measures: Use of contraception among adolescent patients, policy to recommend IUC to adolescents in various clinical scenarios, and barriers to adolescent contraceptive counseling. Results: Over 50% of pediatricians considered abstinence their favored method of contraception for adolescents, while fewer than 20% reported discussing IUC as an option. Female pediatricians were more likely to discuss IUC (25% vs 8%, P = .01), as were younger pediatricians (28% vs 14%, P = .13). Given 8 clinical scenarios suitable for IUC use, less than 25% of pediatricians would offer IUC to a teen unless she had a history of a vaginal delivery or abortion. Seventy percent of pediatricians reported lack of training with IUC, and more than 30% reported legal, fertility and parental concerns as barriers to discussing IUC with adolescents. Conclusions: Efforts are warranted to improve the education of pediatricians regarding the most current guidelines for proper IUC use in adolescents with the goal to increase the frequency with which this effective contraceptive method is discussed with this vulnerable population.