RESUMO
PURPOSE: This study was designed to determine the factors associated with Norplant choice for postpartum teens. METHODS: A total of 151 teenagers, ages 12-20 years, who delivered at the Medical Center of Delaware from July to December 1992, were offered insertion of Norplant within 48 h postpartum. A structured interview was conducted in the postpartum period after nondirective counseling sessions including a physical demonstration using anatomical models of various contraceptive methods. Student's t-tests, chi-square, and multivariate analyses were used. RESULTS: Eighty-six teenagers were African-American (mean age = 17.3 +/- 1.9 years) and 65 non-Hispanic white (NHW) (mean age = 18.3 +/- 1.5 years). The NHW teenagers were older (p < 0.001); the African-American teenagers were more likely to have Medicaid (49% vs. 14%; p < 0.001) and to have one or more friends who use Norplant (62% vs. 34%; p < 0.001). In multivariate analyses, NHW teenagers were more likely to choose Norplant if they had discussed their choice with a parent or guardian [adjusted odds ratio (AOR) = 14.6, 95% confidence interval (CI), 2.12-100.57]; had Medicaid funding (AOR = 12.1; 95% (CI), 10.6-91.34); and had any friends who used Norplant (AOR = 6.3; 95% (CI), 1.38-28.40). However, for African-American teenagers, the strongest predictor for choice of Norplant was number of prior children delivered. After two deliveries, there was a better than four-fold likelihood (AOR = 4.8; 95% (CI), 1.47-15.94) that African-American teenagers would choose Norplant. For the African-American teenagers, parental discussion, Medicaid status, and friends' use of Norplant were not as important as family size, but far greater percentages of the African-American teenagers had access to Medicaid funding and peers who used Norplant. CONCLUSIONS: NHW and African-American teenagers choose Norplant for different reasons. Lack of funding may have been a barrier to choosing Norplant. Discussions with parents and friends have a positive influence on choosing Norplant for NHW teenagers. African-American teenagers were more likely than NHW to have Medicaid coverage, and more frequently choose Norplant if the current birth was their third child.
PIP: 151 youths, aged 12-20 years, who delivered at the Medical Center of Delaware from July to December 1992, were offered insertion of Norplant within 48 hours postpartum. These young women were subsequently interviewed to determine which factors are associated with choosing to accept or not accept Norplant. 86 Black teenagers of mean age 17.3 years and 65 non-Hispanic Whites of mean age 18.3 years participated. The White teenagers were significantly older, 49% of Blacks and 14% of Whites had Medicaid, and 62% of Blacks and 34% of Whites had one or more friends who use Norplant. In multivariate analyses, the White teens were more likely to choose Norplant if they had discussed their choice with a parent or guardian, if they received Medicaid funding, and if they had any friends who used Norplant. The strongest predictor for choice of Norplant among Black teens was the number of prior children delivered. After 2 deliveries, there was an almost 5-fold likelihood that Black teenagers would choose Norplant. For the Black teens, parental discussion, Medicaid status, and friends' use of Norplant were not as important as family size, but larger proportions of the Black teens had access to Medicaid funding and peers who used Norplant.
