Objective: Adolescence is a period characterized by increased exploration and exposure to risk-taking behaviors, including unsafe sex. This study examines prior contraceptive method use by pregnant or recently pregnant adolescents in Teresina-Piauí, Brazil.
Design: Cross-sectional study.
Setting: Four hospital maternity units.
Participants: Two-hundred and seventy-eight adolescents aged 15-19 admitted in four hospital maternity units for clinical treatment or for pregnancy resolution were interviewed.
Methods: The sample was stratified proportional to the number of adolescents who visit each hospital. Chi-square and Fisher exact test are used to analyze differences between contraceptive users and non-users.
Results: Half of interviewed adolescents used some form of contraception at first intercourse (53.2%) and 40.3% used contraception at intercourse leading to the current pregnancy. Male condom was the most common method at first intercourse (96.6% among users of a method) and at the time of pregnancy (58.9%). The main reasons for contraceptive nonuse were that the adolescent had not thought about contraception at the time of first sex (36.1%) and the adolescent wished for a baby at the time of pregnancy (26.5%). About 57% of girls who did not want the pregnancy reported that they did not use any contraceptive method right before the pregnancy. Among pregnant adolescents with an unwanted pregnancy, a greater percentage who had access to health services reported contraceptive use (48%) compared to only 16.7% of those with no access to health services.
Conclusions: Contraceptive method use by adolescents was unsatisfactory as indicated by unwanted pregnancies among both users and nonusers of contraception. Prevention of unintended pregnancies requires greater information and access to contraceptives among all sexually active youth.