Prevention of abortion and unplanned pregnancy. Modern methods of contraception in adolescent girls.

13.02.2025

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“Dangerous age!” - this is how teachers, doctors, and parents characterize the teenage period in a person’s life. It is during this period that the formation of personality occurs, the features of the emotional, cognitive, and volitional spheres of a person are gradually outlined, self-awareness and psychosexual orientation are formed. Sexual relationships among young people are an important area of ​​their lives. Adolescents, regardless of gender, are distinguished by transient hypersexuality and, if a psychological barrier to early sexual debut has not been created through family upbringing, sexual activity can begin already in adolescence

The youth of the Republic of Belarus is characterized by the first type of sexual and reproductive behavior, which occurs mainly in developed countries:

  • onset of sexual activity at the age of about 15-19 years;
  • relatively infrequent use of contraceptives;
  • high incidence of unwanted out-of-wedlock pregnancies;
  • a clear tendency towards the use of abortion
  • high incidence of STIs;
  • committing sexual crimes.

Today, the situation in Belarus is characterized by a low level of awareness among adolescents about family planning, sexuality, sexually transmitted diseases, methods of effective comprehensive contraception, safe sex, etc. Teenagers prefer to receive information from the media, from friends and peers. They try not to discuss relationship issues and intimate problems with their parents, and parents, in turn, believe that there is no need for sex education. In many families, these topics are considered taboo. But in vain, since the solution to the problem of unwanted pregnancy depends 90% on the situation at home and on the upbringing of parents. It is necessary to develop in adolescents a responsible attitude towards the early onset of sexual activity, issues of protection from sexually transmitted infections and unwanted pregnancy. And the sooner parents think about the importance of this topic and begin a confidential conversation with their children, the more positive the result of this conversation will be for them.

Early initiation of sexual relations, combined with a low level of knowledge in this area, poor awareness of contraceptive means and methods and their insufficient use, leads to an increase in the number of teenage pregnancies and, as a consequence, an increase in the number of abortions, adverse birth outcomes and deterioration in the reproductive health of adolescents .

From a social point of view, the birth of a child has an adverse effect on the mother, who is often deprived of the opportunity to continue her education and achieve a higher social and economic status in the future.

In addition to the danger to reproductive health, unwanted pregnancy at this age also has psychological consequences, since artificial termination of pregnancy is a psychotraumatic factor, entailing changes in mental state in the form of emotional lability, irritability and asthenia.

A study of the contraceptive behavior of girls aged 15-19 years showed that sexually active adolescents either do not use protection at all or use ineffective means. Sexual behavior of adolescents in most cases is dangerous sexual behavior, leading in many cases to provocation of sexual assault, unwanted pregnancy and the spread of sexually transmitted infections. That is why the most important thing in solving this problem is the prevention of unwanted pregnancy through the active implementation of educational work in schools. This method plays an important role in working with adolescents. Information about the disastrous consequences of abortion, methods of contraception and ways to avoid unwanted pregnancy should be fully accessible to everyone, regardless of a person’s financial situation, age and social status. Sex education will help you avoid problems associated with teenage sexuality.

The increase in the interval between the age of onset of sexual activity and the birth of the first child, the increase in sexual activity of adolescents make the problem of adolescent contraception relevant.

The main objectives of contraception in adolescents are:

  • prevention of first abortion and unplanned first birth;
  • prevention of sexually transmitted diseases, HIV infection.

For adolescents, any method of contraception other than sterilization is acceptable, but each method must be carefully selected. Teenage contraception must meet the following requirements:

  • high efficiency;
  • safety for health (well tolerated);
  • reversibility;
  • ease of use;
  • availability for purchase;
  • protection against STIs and HIV infection.

When choosing a contraceptive method, you should remember that the behavior of teenage girls differs from the behavior of girls in older age groups and has the following features:

  • irregular sex life;
  • irregular menstruation (up to 25%);
  • insufficient sexuality education;
  • fear of discovery of contraception by parents or loved ones;
  • choosing a contraceptive based on the “advice” of friends;
  • high risk of STIs;
  • having multiple sexual partners.

Consequently, the psychophysiological and social characteristics of adolescents dictate the need for a particularly careful and individual selection of a contraceptive.

Today there are many methods of contraception. Based on the properties of each method, the following four methods of contraception are recommended for teenage girls:

  • barrier (mechanical);
  • spermicidal (chemical)
  • hormonal;
  • emergency contraception (EC) methods.

Let's look at each method in more detail.

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Barrier methods of contraception are based on the use of means that create a mechanical obstacle to the penetration of sperm into the cervical canal. In our country, this method is represented by condoms. A condom protects not only from unwanted pregnancy, but also from sexually transmitted diseases, and is also the most accessible method for adolescents. The main disadvantage is the frequent rupture of the condom, which reduces the contraceptive effectiveness of this method of contraception.

Spermicidal methods of contraception are based on the use of agents that have a detrimental effect on sperm: they contain an active ingredient that destroys the cell membrane of the sperm within a few seconds. Spermicidal substances are available in the form of creams, gels, foams, suppositories, tablets, and soluble films. The active components of most spermicides are nonoxynol-9 or benzalkonium chloride, which, in addition to their destructive effect on sperm, have bactericidal, antiseptic and viruscidal effects.

With the combined use of spermicides and barrier methods, the contraceptive effect increases. The advantage of barrier and spermicidal methods of contraception is also the possibility of using them for irregular, episodic sexual activity, which is important for adolescents.

Hormonal contraception is the most reliable method of reversible pregnancy prevention with almost 100% effectiveness and therefore occupies one of the leading places in the world among birth control methods. The most common pills used among adolescents are combined oral contraceptives (COCs). At the same time, young girls should not choose a COC based only on information on the Internet or on the advice of a friend, but should always consult a doctor who will take into account the girl’s health, her heredity, intensity of sexual activity and much more. A major disadvantage of birth control pills is that they do not protect partners from STIs. The most reliable method is called the “double Dutch method of birth control,” when oral contraceptives are used simultaneously with a condom, which, along with high efficiency, provides protection against STIs.

Emergency (urgent, emergency) contraception (EC) is necessary to prevent the development of pregnancy after unprotected sexual intercourse (sexual intercourse without a condom, spermicides or hormonal contraceptives) or in case of improper use of these means (condom rupture, injection of spermicides only after sexual intercourse, in case when a girl forgot to take one or more birth control pills). In some situations, EC is the only method of contraception and is used as an emergency measure of protection not only against unwanted pregnancy, but also against mental and physical trauma (rape, forced sexual intercourse). And certainly EC is an adequate alternative to abortion. However, do not forget that any EC pills are used only in emergency cases and cannot be used for regular contraception. After using an emergency remedy, you must consult a doctor to select permanent, reliable contraceptives.

Thus, today there is a huge selection of contraceptive means and methods. When prescribing a contraceptive method, it is necessary to select it individually, taking into account the nature and degree of responsibility of the teenager, the intensity of his sexual life, since correctly selected, timely contraception significantly increases the chances of maintaining the reproductive health of a teenage girl who will become a mother in the future.

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Obstetrician-gynecologist, office of gynecological care for adolescents, 4th antenatal clinicShetskaya E.S.

Obstetrician-gynecologist (head of the 4th antenatal clinic)Degileva I.N.