- Adolescents face barriers to medical abortion (MAB) follow-up but have higher rates of follow-up compared with older women.
Why this matters
- 82% of pregnancies in adolescents are unplanned.
- MAB (mifepristone and misoprostol) has a success rate of 95%-96%.
- Follow-up rate was 51.8% for adolescents, 43.1% for 20-24-year-olds, 40.5% for 25-39-year-olds (P=.001).
- 79.2% of adolescents received screening for sexually transmitted infections; 21.6% of those had a positive result.
- 18.1% reported illicit substance use.
- Black adolescents were less likely to have follow-up compared with Hispanic and non-Hispanic women (relative risk [RR], 0.76; 95% CI, 0.66-0.89).
- Women in college were more likely to have follow-up (RR, 1.43; 95% CI, 1.03-1.98).
- Of women who did have follow-up, 3.2% had a persistent intrauterine pregnancy.
- Of women who followed-up, 18% chose long-acting reversible contraception; 18% selected no contraception.
- Retrospective chart review.
- Cohort from Cook County Hospital.
- Adolescent patients (15-19 years) undergoing MAB were identified using a billing database (n=446).
- For each adolescent, randomly selected patients age 20-24 years and age 25-39 years, respectively, were used for comparison.
- Information on sociodemographics, follow-up, and contraception history extracted from records.
- Funding: None.
- Low follow-up rates may affect true rate of MAB failure.