Consultation patterns and provision of contraception in general practice before teenage pregnancy: case-control study

In western Europe, UK has the highest teenage pregnancy rate among 15-19 year olds. Although general practice is one source of provision of contraception, it has been suggested that teenagers are reluctant to seek advice because of difficulty in gaining access and fears about confidentiality. This case-control study determined patterns of consultation in general practice and provision of contraception before teenage pregnancy. A total of 240 cases with a recorded conception before age 20 and 719 matched controls were identified. Overall, results show that most teenagers who became pregnant attended a general practice in the year before pregnancy, and many had sought contraceptive advice. Cases were more likely to have consulted a doctor in the year before conception than controls (odds ratio, 2.70; 95% confidence interval, 1.56-4.66). An association between provision of emergency contraception and pregnancy ending in termination was found. This finding emphasizes the need for continuing follow-up of teenagers consulting for this form of contraception.