The proportion of U.S. women using some form of contraception in their first month of sexual activity increased over a 45-year period, largely due to the use of condoms, but many teens still risk unwanted pregnancy by delaying contraceptive use, according to a study in the February 2019 Pediatrics.
The study, "Contraceptive Initiation Among Women in the U.S.: Timing, Methods Used and Pregnancy Outcomes," analyzed data from the National Survey of Family Growth, 2002-2015, to calculate outcomes from self-reported dates of sexual debut, contraceptive initiation and unwanted pregnancy.
Researchers analyzed responses from 26,359 women with sexual debuts between 1970-2014 to identify trends, noting that the average US woman becomes sexually active around age 17. The study authors found that contraceptive use around the time of sexual debut has become increasingly common, though most US teenagers and young adults still rely on condoms alone for pregnancy prevention during their first month of sexual activity.
They also found that women with delayed contraceptive initiation (after their first month of sexual activity) were 4 times more likely to experience an unwanted pregnancy within 3 months of sexual debut, compared with women who started using any form of contraception during their first month of sexual activity. Of note, US women 18 to 24 years old have the highest rates of unintended pregnancy, which is associated with delayed prenatal care, premature birth and low birth weight. Unintended pregnancy is more common among Black, Hispanic and low-income women.
Researchers suggest that delayed contraceptive initiation may be a driver of important reproductive health disparities, and that health care providers play a key role in a making timely contraception available to teens when and before they become sexually active.
Additional Information from HealthyChildren.org: