Teenagers in rural and regional areas may not be receiving the level of contraceptive support they need, according to GPs interviewed in a new study from Monash University's SPHERE Centre of Research Excellence.
The new study Contraceptive counselling in regions of Victoria with high incidence of teenage pregnancy: general practitioners' insights has been published in the Australian Journal of Primary Health.
The study sought rural GPs' insights on the provision of contraception information to teenagers, including their approaches to contraceptive counselling.
Most of the 18 GP participants in the study reported that the higher rates of teenage pregnancy in their region were likely related to limited knowledge of and access to contraception, saying teens often experience barriers due to socioeconomic status, the costs associated with some contraceptive methods, and the limited providers available to insert long-acting reversible contraceptives (LARCs).
The study found building rapport with teenagers, along with a focus on normalising contraceptive discussions and empowering teenagers to make informed contraceptive choices, could improve contraception use and reduce unintended pregnancies.
Lead author, SPHERE Senior Research Fellow Dr Jessica Botfield, said the findings show GPs could better support teenagers in learning about contraception options.
"Ensuring teenagers feel general practice is a safe place to discuss sexual and reproductive health issues was seen as important, to put them at ease and improve engagement in contraception discussions," Dr Botfield said.
The study found that supporting informed decision-making and facilitating access to all methods of contraception for teenagers, including those in regions with higher incidence of teenage pregnancy, will require normalising contraception discussions, addressing misunderstandings among GPs regarding intrauterine device (IUD) suitability for teenagers, and increasing the number of IUD-inserting GPs.
"Building on GPs' current efforts to provide contraception information and support to young people, and discussing contraception as part of routine care for teenagers, will further support these endeavours," Dr Botfield said.
The results of this study support the Federal Government's recent announcement of additional LARC training centres of excellence, training opportunities and financial incentives for GPs and other primary care practitioners for LARC insertion, and subsidies that significantly lower the cost for women to access these methods.
The research paper cites earlier research that:
- One-quarter of women in Australia have experienced an unintended pregnancy, with rates even higher in rural areas and among younger women.
- Unintended pregnancies can be primarily attributed to inconsistent or non-use of contraception or contraceptive failure.
- Teenage pregnancy and parenthood are associated with higher risks of maternal mortality and morbidity, experience of violence, and violation of rights to education, employment, and reproductive health.
- Teenage mothers are more likely to experience obstetric complications, and their children are at higher risk of low birth weight and preterm delivery compared to older mothers.
- Younger women are more likely to use less-effective methods of contraception such as the oral contraceptive pill, condoms, and withdrawal.
- Limited availability of healthcare practitioners trained in insertion and removal procedures for long-acting reversible contraceptives, including the contraceptive implant and IUDs, impedes uptake of these more effective methods, particularly in rural areas of Australia.
Read the full paper in Australian Journal of Primary Health DOI: 10.1071/PY24169
