Leveraging Pediatric Infant Visits to Improve Access to LARC for Teen Mothers
Statement of Problem
Unintended pregnancies, a measure that includes both unwanted and mistimed pregnancies, account for 73 percent of teen pregnancies in Pennsylvania. Additionally, 20 percent of teen births occur to those who are already mothers. Long-acting reversible contraceptives (LARCs) are the most effective form of contraception and can reduce repeat pregnancies for mothers, but few young women use them. As PolicyLab researchers have previously identified, there is an overwhelming amount of evidence demonstrating the safety and efficacy of LARCs, yet they are rarely a provider’s or patient’s first choice contraceptive.
We also recognize while many mothers never return to their own physicians for postpartum care, almost all report visiting the pediatrician’s office. Pediatric clinicians are, therefore, well positioned to provide intergenerational services to teen mothers to reduce unintended pregnancies, such as counseling about LARCs and referral to Obstetrics/Gynecology.
To identify teen mothers with unmet contraceptive needs, our team is working to leverage infant well-child visits to immediately connect young women with LARC-proving clinicians. By doing so, we expect more women will use LARCs and unplanned pregnancies will decrease.
Since teen mothers are not often our patients, we are using the electronic health record (EHR) to identify them. For those mothers, prompts in the EHR will encourage pediatric clinicians to document maternal age, contraception preferences, unmet needs and barriers to accessing birth control. To ensure women are then connected to appropriate resources, our participating pediatric clinicians will have established contacts in our own Adolescent Medicine division, as well as in local Obstetrics/Gynecology and Family Medicine practices who can provide proactive outreach for mothers without scheduled postpartum visits.
By identifying and offering support to teen mothers in the pediatric health system, we can move towards a healthier life for both mother and her child and prevent unintended pregnancies. We hope that this project will be the first step in leveraging our EHR to improve perinatal outcomes at the population level by more effectively promoting health for young mothers seeking care in the CHOP system.
This project page was last updated in January 2019.
Children's Hospital of Philadelphia, PolicyLab. Leveraging Pediatric Infant Visits to Improve Access to LARC for Teen Mothers [Online]. Available from: http://www.policylab.chop.edu [Accessed: plug in date accessed here].