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CME Credit Offered
CME Credit Offered
Abstract Award
Abstract Award
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Poster Session 4

(957) The Impact of the SCOTUS Dobbs Decision on Adolescent Postpartum Contraceptive Method Selection

Friday, January 31, 2025
4:00 PM – 6:00 PM  

    Coauthor(s)

  • ZK

    Zuha Khan

    University of Tennessee
    Knoxville, Tennessee, United States

    • Submitting Author(s)

  • Alicia Mastronardi, MPH (she/her/hers)

    University of Tennessee Graduate School of Medicine, Department of OB/Gyn
    Knoxville, Tennessee, United States

    • Presenting Author(s)

  • Megan L. Young, MPH (she/her/hers)

    University of Tennessee Medical Center, Center for Women and Infants
    Knoxville, Tennessee, United States

    • Coauthor(s)

  • ZS

    Zachary J. Shelton, BS

    Research Assistant
    University of Tennessee Graduate School of Medicine, Department of OB/Gyn
    Knoxville, Tennessee, United States

  • WH

    William S. Havron, IV, BS

    Research Assistant
    University of Tennessee Graduate School of Medicine
    Knoxville, Tennessee, United States

  • JM

    Jill M. Maples, PhD

    Associate Professor
    University of Tennessee Health Science Center, College of Medicine
    Knoxville, Tennessee, United States

  • NZ

    Nikki B. Zite, MD, MPH

    Professor, Vice Chair
    University of Tennessee Graduate School of Medicine
    Knoxville, Tennessee, United States

Objective: To investigate the potential impact of the SCOTUS Dobbs Decision on postpartum adolescent contraceptive method selection immediately postpartum in a state with high teen birth rates.

Study Design: This retrospective cohort study used electronic health delivery records two years before (May 2020-April 2022) and after (May 2022-April 2024) the Dobbs Decision leak. Patients < 20 years old were analyzed and those with no documented contraceptive preference were excluded. Contraceptive methods were categorized based on the American College of Obstetricians and Gynecologists efficacy categories: highly effective (implant, IUD, sterilization), medium effective (injection, pill, patch, ring), least effective (condom, fertility awareness-based methods), and no plan/abstinence. Pearson Chi-square tests were performed in SPSS to compare contraceptive methods, recall of prenatal contraceptive counseling, and other demographic characteristics including residence categorized by March of Dimes maternity care access level, race and ethnicity, and insurance status.

Results: Analysis included 786 adolescent births (47.7% pre-Dobbs; 52.3% post-Dobbs). After the Dobbs decision, a higher percentage of postpartum adolescents opted for no contraceptive method (1.9%, 9.2%), while fewer adolescents opted for the highly effective contraception (44.0%, 38.7%), (p< 0.001). Additionally, recall of contraceptive counseling decreased post-Dobbs (59.7% to 48.7%, p= .027). Demographics considered, including maternity care access level, were not significantly different between contraceptive method efficacy categories.

Conclusion: Postpartum adolescents showed a greater tendency to select no contraception post-Dobbs. The decreased recollection of prenatal contraceptive counseling may contribute to that finding. Greater effort is needed to ensure prenatal contraceptive counseling and access to all methods immediately postpartum as this may decrease repeat teen pregnancy.