Consultation patterns and provision of contraception in general practice before teenage pregnancy: case-control study

doi:10.1136/bmj.321.7259.486

BMJ 2000;321:486-489 ( 19 August )

General Practice

Consultation patterns and provision of contraception in general practice before teenage pregnancy: case-control study

Editorial by Donovan

Dick Churchill, clinical lecturer, ^a Jane Allen, researcher, ^a Mike Pringle, professor, ^a Julia Hippisley-Cox, senior lecturer, ^a Dave Ebdon, lecturer, ^b Marion Macpherson, consultant, ^c Sue Bradley, lecturer. ^d

^a Division of General Practice, University of Nottingham Medical School, Queen's Medical Centre, Nottingham NG7 2UH, ^b Department of Geography, University of Nottingham, Nottingham NG7 2RD, ^c Department of Obstetrics and Gynaecology, Queens Medical Centre, Nottingham, ^d School of Nursing, Queen's Medical Centre, Nottingham

Correspondence to: R Churchill dick.churchill{at}nottingham.ac.uk

Objectives: To determine patterns of consultation in generalpractice and provision of contraception before teenagepregnancy.
Design: Case-control study, with retrospective analysisof casenotes.
Setting: 14 general practices in Trentregion.
Subjects: 240 registered patients (cases) with a recordedconception before the age of 20. Three controls per case werematched by age andpractice.
Main outcome measures: Consultations in general practice and provisionof contraception in the 12 months before conception and recordedprovision of contraception at any time beforeconception.
Results: Overall, 223 cases (93%) had consulted a healthprofessional at least once in the year before conception, 171(71%) had discussed contraception in this time, and 121 (50%)had been prescribed oral contraception. Cases were more likelyto have consulted in the year before conception than controls(odds ratio 2.70, 95% confidence interval 1.56 to 4.66). Mostof the difference was owing to consultation for contraception.Overall, 53 cases (22%) resulted in a termination of pregnancy.Cases whose pregnancy ended in a termination were more likelyto have received emergency contraception than either their controls(3.21, 1.32 to 7.79) or cases resulting in other outcomes (3.01,1.06 to 8.51).
Conclusions: Most teenagers who became pregnant attendedgeneral practice in the year before pregnancy, and many had soughtcontraceptive advice. The reluctance of teenagers to attend generalpractice for contraception may be less than previously supposed.The association between provision of emergency contraception andpregnancy ending in termination emphasises the need for continuingfollow up of teenagers consulting for this form ofcontraception.

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Rapid Responses:

Read all Rapid Responses

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Re: Re: Re: Abortion also an evil: James S Smeltzer
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