WCH CONNECTMay 20, 2019

Evaluating contraception use among youth at-risk for unintended pregnancy

  • May 20, 2019
  • BY Sarah Warr
Dr. Sheila Dunn
Dr. Sheila Dunn

Unintended pregnancy can have profound impacts on an individual’s physical and emotional health, educational attainment and career aspirations. Non-use of contraception among sexually active youth is a significant cause of unintended pregnancy and also a major health concern for this group. A recent study from Dr. Sheila Dunn, family physician and research director at the Family Practice Health Centre and scientist at Women’s College Research Institute (WCRI), assessed rates of non-use of contraception and risk factors for non-use among Canadian youth aged 15 to 24.

By the age of 24, 86 per cent of Canadians have had sexual intercourse, with almost three per cent of Canadian women aged 15 to 19 becoming pregnant each year. The study, published in the Journal of Obstetrics and Gynecology Canada, found that 15.5 per cent of youth at risk for unintended pregnancy didn’t use contraception during their most recent intercourse – equal to approximately 300,000 Canadian youth. They also found that rates of non-use of contraception varied considerably across regions of Canada.

As non-use of contraception comes with high personal and societal costs, Dr. Dunn sought to determine which factors are associated with non-use to inform the development of health policies and services to better address the sexual health needs of youth. The scientists found that those at high-risk for unintended pregnancy and most likely to be non-users of contraception were younger teens and youth who are poorer, born outside Canada and/or Indigenous.

“There is a strong need for targeted outreach, culturally-tailored sexual health education and easily accessible sexual health services for youth across Canada,” says Dr. Dunn. “Schools provide an opportunity for sexual health education to demystify contraception, reduce risky sexual practices and enhance equitable contraception practices.”

The study's authors suggested that the policies and attitudes adopted in Quebec – where there is the highest percentage of at-risk youth but lowest percentage of non-users of contraception – should be adopted widely. The province instituted a program allowing nurses and pharmacists to provide hormonal contraception to healthy women and girls, as well as providing free contraceptives to youth under 25 who live with their parents and attend school. Sexual health strategies such as these have proven to support knowledge about contraception and increase use among those at high-risk for unintended pregnancy.

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