Approximately 750,000 adolescents become pregnant each year. Of these pregnancies,
80% are unplanned, demonstrating an unmet need for contraception among adolescents.
We examined the ability and barriers to minors obtaining contraceptives confidentially
through pediatric/family medicine practices in the District of Columbia.
This is a cross-sectional study in which pediatric/family medicine practices in Washington,
DC were surveyed through a mystery caller approach. The caller stated that she is
16 years old and surveyed the clinic regarding contraceptive-related information.
Fifty-five practices were selected from the Washington, DC Department of Health website.
The primary outcome was the proportion of practices that offer long-acting reversible
contraceptives (LARCs), Depo Provera, or oral contraceptive pills (OCPs) to underage
patients. The secondary outcomes included same-day procedure availability, required
parental consent, and time to first appointment.
Nearly all practices (n=51/55, 93%) were reached. Of the 55 practices, 27 were pediatric,
and 28 were family medicine. Of practices reached, 39.1% offered LARC methods, 50.9%
Depo-Provera, and 81.8% OCPs. Parental consent was required by 41.2% of practices.
Of practices that offered LARCs, only 7.3% were offering same-day procedures (p=0.02).
The average waiting period to first available appointment was 37.3 days.
Overall, various contraceptives are available for adolescents in pediatric/family
medicine practices across Washington, DC. However, the majority do not offer LARCs.
Other barriers to care include long waiting periods for first appointment, need for
multiple appointments and required parental consent. Despite Washington, DC law allowing
minors to consent to contraceptive services, 41.2% of the practices surveyed still
required parental consent.