(64) Immediate postpartum IUD use among adolescents in the United States: Update from National Inpatient Sample

Background: Intrauterine devices (IUDs) are a highly effective method of contraception and are the recommended form of contraception in adolescents. Immediate postpartum IUD placement is associated with lower rates of unintended pregnancy and short interval pregnancy, both of which are prevalent in adolescents. Data regarding immediate postpartum IUD use is not widely available; at the same time, understanding utilization of immediate postpartum IUDs in adolescents is crucial for local, regional, and national resource allocation, safety monitoring, and public health efforts in surveillance of unintended adolescent pregnancy rates.

Methods: National Inpatient Sample (NIS) data was used. Most recently available data comprised of years 2019 and 2020 were requested. Analyses were conducted using descriptive statistical methods and chi-square. The study was deemed exempt from Institutional Review Board (IRB) review.

Results: The results of the analysis revealed noteworthy disparities in immediate postpartum IUD usage across various age groups among adolescents and young adults. Specifically, within the adolescent population, aged 12 to 15 years, 2.0 percent received immediate postpartum IUDs in 2019 and 2020. This rate was lower among adolescents aged 16 to 19 years, where 0.7 percent received immediate postpartum IUDs. Furthermore, in the adult age group of 20-24 years, the immediate postpartum IUD usage was found to be 0.6 percent. The differences in immediate postpartum IUD usage across different age groups were found to be statistically significant. With regard to geographic distribution, immediate postpartum IUD use was more common in counties of medium-sized metro areas compared with both large metro areas and small metro or non-metro areas.

Conclusions: Overall utilization of immediate postpartum IUDs remains low. However, our data analysis highlights that the usage is notably higher among younger adolescents aged 12 to 15 years. Insights into national trends are essential for developing focused strategies to improve access to effective contraception methods among adolescents, helping to reduce unintended pregnancies in this vulnerable population.