Study endorses proactive contraception for teens

Teenagers should be proactively provided with contraceptives as the current system is ‘‘not working’’, Kiwi researchers say.

A paper, led by former University of Otago PhD student Dr Rebecca Duncan, said New Zealand’s high adolescent pregnancy rates were influenced by limited access to contraception.

Duncan said the country’s adolescent rates of effective contraception stacked up ‘‘poorly’’ globally – more than 93 per cent of pregnancies in those aged 15-19 were unintended, and consistent contraceptive use among Kiwi adolescents had decreased since 2001.

‘‘The current system is not working, and the consequences for those it fails are lifechanging.’’

In 2013, New Zealand had 23.8 births per 1000 women aged 15 to

19, a rate second only in the developed world to the United States, the paper, published in the Australian and New Zealand Journal of Obstetrics and Gynaecology, said. Of Kiwi adolescents aged 17 and over, 40.5 per cent had had sex – but only 52 per cent of sexually active adolescents used contraception consistently, the research said.

Duncan said while there were a range of contraceptives available in New Zealand, the current provision of contraception to adolescents was reactive rather than proactive.

She said it was also not focused on long-acting reversible contraceptives (Larcs), and therefore ‘‘may not be as effective as it could be’’.

Uptake of Larcs, such as implants and intrauterine devices, was low for all ages – despite being ‘‘22 times as effective’’ as oral contraceptive pills, the research said.

Duncan said this was partly due to a lack of awareness among providers that Larcs were suitable options – a problem ‘‘disproportionately affecting adolescents’’, even though guidelines say they are safe for this group.

She said a proactive system – offering confidential and free consultations to all adolescents, regardless of sexual activity – would ideally result in increased contraceptive use and a reduction of unintended teen pregnancy.

Proactively providing contraception would also give young people greater control of their reproductive and sexual health, she said.

‘‘The current system is not working.’’ Dr Rebecca Duncan Otago PhD student