74. Contraceptive Use and Pregnancy Among a Sample of Trafficked Adolescents

• Published in: Journal of pediatric & adolescent gynecology 2023-04, Vol.36 (2), p.205-205
• Main Authors: Labine, Monica, Lemke, Monika, Hall, Deborah, Deye, Katherine
• Format: Article
• Language: English
• ISSN: 1083-3188; 1873-4332
• DOI: 10.1016/j.jpag.2023.01.162

Domestic Minor Sex Trafficking (DMST) is known to cause significant morbidity and mortality specifically related to sexual and reproductive health. Female adolescents who experience trafficking have higher rates of sexually transmitted infections, unwanted or forced pregnancies, forced abortions, and maternal and infant complications. This study aims to describe hormonal birth control use and pregnancy among a sample of trafficked adolescents. An IRB-approved retrospective manual chart review was conducted to extract data from the electronic health record on sexual and reproductive health. Female patients from a known trafficked and high-risk for trafficking cohort who had sexual and reproductive health information documented in a medical visit between January 2020 and July 2022 were eligible for inclusion. Additionally, patients had to be 21 years old or younger in 2021 to be included. Descriptive statistics were used to describe trends in hormonal birth control use and pregnancy in this sample. A total of 128 females ages 8 to 21 were included. The majority were Black (88%) and on public insurance (85%). Of the 128, 48% (N=61) had documentation of a pregnancy at some point in their life, and the average age of first pregnancy was 16 years old. Of the girls ever pregnant, 41% (N=25) had multiple pregnancies. Of the 97 reported pregnancies, 43% (N=42) were unintended and 6% (N=6) were intended. Intention could not be determined for 51% (N=49) of the reported pregnancies, which either occurred prior to referral to our clinic or did not disclose desire for pregnancy. Outcomes for the 97 births included live birth 39% (N=38); miscarriage 25% (N=24); termination via abortion 23% (N=22); and unknown outcomes 13% (N=13). Although 79% (N=101) of the sample had ever used hormonal birth control, continuation rates in general were low, rarely exceeding a year except for Nexplanon (59%, 20/34) and IUDs (60%, 3/5). The most used form of contraception, the Depo-Provera shot, was typically given only once (52%) due to delayed administration of the subsequent doses or abnormal uterine bleeding. The number of methods ever used ranged from 0 to 5 with the most common being one method (25%, N=32), and two methods (25%, N=32). High pregnancy rates among trafficked adolescents highlight the importance of sexual and reproductive health services and family planning resources. Low contraception continuation rates and the elevated risk of adolescent maternal and fetal complicatio