Adolescent emergency contraception: Training experiences among residents in pediatrics, family and emergency medicine
Awarded 2014
Complex Family Planning Fellowship Research
Amber Truehart, MD
University of Chicago

Background: Obstetrician-gynecologists are rarely an adolescent’s first contact with the health care system. Most adolescent visits are with pediatricians and family practitioners. A large number of uninsured adolescents have no primary care provider and rely on emergency departments for routine care. These providers, termed “frontline adolescent providers”, who have routine contact with adolescent patients have an opportunity to discuss emergency contraception (EC) with adolescents in both primary care and acute care settings.
Purpose: To examine training experiences and exposure to emergency contraception counseling during residency among frontline adolescent providers.
Methods: Semi-structured individual interviews were conducted from June – October 2014 with 24 residents from four urban, academic institutions. Interviews were digitally recorded, transcribed, and analyzed for salient themes.
Important findings: Few residents had personally counseled adolescents about EC. Residents reported EC being within their scope of practice but we found that people’s perception of their role in EC counseling depended on the way in which they viewed their own specialty. Those that viewed their specialty as preventative saw EC as different from, and even the opposite of, “maintenance contraception” and as an emergency intervention. As such, they believed EC counseling primarily should take place in an acute care setting. However, those who were engaged in emergent care saw EC as a primary care intervention, unless it was in the case of sexual assault, and believed this counseling should be occurring during a scheduled clinic visit before need of the method.
Conclusions: Frontline adolescent providers have a critical role in adolescent health care. Reframing EC as having diverse roles along the continuum of prevention and acute treatment may ensure that a wider variety of clinicians engage in EC counseling.