American Academy of Pediatrics. AAP Updates Recommendations on Teen Pregnancy Prevention. 2014.
Over the past 10 years, a number of new contraceptive methods have become available. The American Academy of Pediatrics (AAP) continues to review and update its recommendations on contraceptive methods to provide pediatricians with the information they need in order to counsel and prescribe contraception for adolescents. In an updated policy statement and accompanying technical report in the October 2014 Pediatrics, “Contraception for Adolescents,” (published online Sept. 29), the AAP recognizes the pediatrician’s role as a trusted advisor and source of sexual health information, and supports adolescents and their families to discuss and ask questions about sensitive issues such as sexual health and relationships. According to AAP recommendations, pediatricians will conduct a developmentally-targeted sexual history, assess risk for sexually transmitted infections, and provide appropriate screening and/or education about safe and effective contraceptive methods. Regardless of which method of contraception is chosen, pediatricians should stress that all methods of hormonal birth control are safer than pregnancy, allow adolescents to consent to contraceptive care, and become familiar with state and federal laws regarding disclosure of confidential information in minors. New in this report is the recommendation that the first-line contraceptive choice for adolescents who choose not to be abstinent is a Long Acting Reversible Contraceptive (LARC), which is an intrauterine device or a subdermal implant. The past decade has demonstrated that LARCs, which provide 3 to 10 years of contraception, are safe for adolescents. Pediatricians should be familiar with counselling, insertion, and /or referral for LARCs. Additional updates to the policy statement focus on patients with special health care needs, including physical or developmental disabilities, medically complex illness, and obesity. It is important for pediatricians to regularly update patients’ sexual histories and allow sufficient time for follow up appointments when needed. Pediatricians are also encouraged to promote healthy sexual health decision-making, such as abstinence and proper condom use.
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