Postpartum Contraception in Indonesian Teenager


Background : Teenage pregnancy is a worldwide problem bearing serious social and medical implications relating to maternal and child health. Postpartum contraception in Indonesia teenager still being controversy issue in  Indonesia, some opinion said contraception using in teenager will increase risk of sexual transmitted disease and against sociocultural. However, contraception is still important to prevent another unintended pregnancies. We aimed to evaluate the postpartum contraception preferences of teenagers.

Methods : This is a cross sectional study performed over a period of 2 Years (January 1, 2013 to December 31, 2014) in Dr. Cipto Mangunkusumo Hospital as tertiary center and teaching hospital in Indonesia, 350 randomly selected teenage mothers (aged 12-19) were compared with 350 randomly adult primigravida mothers (20-39 years). Variables of interest were the demographic characteristics of the women, their obstetric complications and the outcome compare with contraception preferences.

Results : There were a total of 5449 deliveries during the study period, out which 372 (6.8%) were teenagers. In teenage group, the mean of age was 17,3 years old, most of the teenage mother latest education were junior high school (78,3%), unemployed (55,1%), married < 6 month (40,8%), unintended pregnancy (56,6%), labor husband occupation (56%). The most commonly used postpartum contraceptive method was IUD (78,9%), DMPA injection (10%), implant (0,3%), and some of adolescent mothers did not use contraception (10,9%). There is significantly different contraception preferences between teenage mothers and adult primigravida mothers (p=0.009). Post partum contraception preferences in teenage mothers were significantly correlate with mother occupation (p=0.002), marital status (p=0.000), marriage age (p=0.000), unintended pregnancy (p=0.004), husband occupation (p=0.000), complications during pregnancy and delivery (p=0.000), gestational age (p=0.000), and babies birth weight (p=0.000). Teenage mother were given information about contraception by doctor after she came at delivery room. The doctor offered several postpartum contraception that can be used after delivery. Teenagers select a contraceptive method with consider the benefits and risks.

Conclusion : Providing adequate postpartum contraceptive education is therefore important for teenage mother.

[1] P. McIntyre, Married Adolescents: No Place of Safety, WHO, Oxford, UK, 2006.

[2] M. L. Hediger, T. O. Scholl, J. L. Schall, and P. M. Krueger, Young maternal age and preterm labor, Annals of Epidemiology, 7, no. 6, 400–406, (1997).

[3] Second World Situation Report. Geneva 1992. Available from: layout/modules/resources/files/rwns2_1.pdf.

[4] M. I. Santos and F. Rosário, A score for assessing the risk of first-time adolescent pregnancy, Family Practice, 28, no. 5, 482–488, (2011).

[5] Adolescent Sexuality, WHO (Original source is The World’s Women 1990, UN Department of Economic and Social Affairs, New York). Geneva 2000. Available from:

[6] N. Bozkurt, U. Korucuoglu, F. N. Aksakal, A. Biri, B. Ciftçi, I. Maral, B. Tiras, U. Korucuoğlu, and B. Tiras, Turkish adolescents’ knowledge on and attitude toward emergency contraception, J Pediatr Adolesc Gynecol, 19, p. 391, (2006).

[7] V. Chandra-Mouli, D. R. McCarraher, S. J. Phillips, N. E. Williamson, and G. Hainsworth, Contraception for adolescents in low and middle income countries: Needs, barriers, and access, Reproductive Health, 11, no. 1, article no. 1, (2014).

[8] T. C. Clark, S. Crengle, J. Sheridan, D. Rowe, and E. Robinson, Factors associated with consistent contraception and condom use among Māori secondary school students in New Zealand, Journal of Paediatrics and Child Health, 50, no. 4, 258–265, (2014).

[9] D. C. Arkan, M. Kaplanoglu, H. Kran, A. Ozer, A. Cos, E. Turgut, M. Kaplanoğlu, and A. Coskun, Adolescent pregnancies and obstetric outcomes in southeast Turkey: data from two regional centers, Clin Exp Obstet Gynecol, 37, no. 2, 144–147, (2010).

[10] K. I. Kennedy and C. M. Visness, Contraceptive efficacy of lactational amenorrhoea, The Lancet, 339, no. 8787, 227–230, (1992).

[11] S. Adjie, Pengaruh model pelatiham teknik khusus pemasangan AKDR cooper T Cu380A pascaplasenta terhadap peningkatan penerimaan, penurunan ekspulsi dan infeksi serta mempertahankan pengetahuan dan ketrampilan provider, Desertasi Doktoral FKUI; February, (2014).

[12] B. A. Cromer, J. M. A. Blair, J. D. Mahan, L. Zibners, and Z. Naumovski, A prospective comparison of bone density in adolescent girls receiving depot medroxyprogesterone acetate (Depo-Provera), levonorgestrel (Norplant), or oral contraceptives, Journal of Pediatrics, 129, no. 5, 671–676, (1996).

[13] R. H. Allen, D. Bartz, D. A. Grimes, D. Hubacher, and P. O’Brien, Interventions for pain with intrauterine device insertion., Cochrane database of systematic reviews (Online), no. 3, (2009)., CD007373.

[14] S. L. Tornello, R. G. Riskind, and C. J. Patterson, Sexual orientation and sexual and reproductive health among adolescent young women in the United States, Journal of Adolescent Health, 54, no. 2, 160–168, (2014).