After giving birth, a 19-year-old Baltimore resident headed to Planned Parenthood and got her first injection of the contraceptive Depo-Provera. One year later, she "likes Depo because I don't have time to remember to take the pill."
This young mother is one of the many teens who are finding Depo-Provera a more convenient, more reliable method of birth control. In fact, family planning counselors say the reason teen pregnancy rates have dropped in both Baltimore and the nation is due, in part, to Depo-Provera.
Known simply as "the shot" among teens, Depo-Provera is an injectable hormone that prevents a woman's egg cells from ripening. As opposed to birth control pills, taken daily, Depo-Provera requires an injection, in the buttocks or upper arm, only once every three months.
The shot, available in the United States since 1993, costs about the same per year as the pill, says its maker, Pharmacia & Upjohn.
In Baltimore, the teen pregnancy rate fell 8 percent from 1995 to 1996; out of 1,000 teen girls, 91 got pregnant in 1996 vs. 99, according to city health statistics. Nationally, the 1995 rate -- 101 per 1,000 -- was the lowest since 1975, says the Alan Guttmacher Institute, a reproductive-health research group in New York.
The shot gets a lot of the credit. "Since 1993, within our affiliate alone, the use of Depo-Provera has gone up tenfold, from 0.8 percent in 1993 to 11.4 percent in 1998," says Patricia Glongoff, director of clinical services at Planned Parenthood of Maryland in Baltimore. "It really appears that we are winning the war against teen pregnancy."
Glongoff says community organizations -- including schools, churches and athletic leagues -- need to educate teens about contraception options. "The benefits of Depo-Provera could be better utilized through education," she says.
The shot is most popular among urban teens, and Glongoff says 10 to 15 percent of the teens on contraception in the Baltimore Planned Parenthood population are using Depo-Provera.
The 1995 National Survey of Family Growth found that 37 percent of women between ages 15 and 19 using contraception chose Depo-Provera. The pill, more well-known, was still most popular, with male condoms No. 2 and Depo-Provera third.
Much of Depo-Provera's success is due to its inconspicuous nature, particularly for teens who don't want to tell their parents they are sexually active. Furthermore, federal law allows teens to be treated in federally funded family planning clinics without parental consent.
Eileen Pagano, a nurse midwife in Baltimore, says her Depo-Provera clients have "generally been happy with the contraceptive. The most common complaint is breakthrough bleeding, which usually subsides after three months."
Doctors and family planning counselors warn that the shot will not provide protection from HIV/AIDS and other sexually transmitted diseases. At Planned Parenthood in Baltimore, counselors discuss the benefits and drawbacks of Depo-Provera with their patients. "We also take a personal medical history to ensure there is no risk for the women involved," says Glongoff.
* Planned Parenthood of Maryland, Baltimore: 610 N. Howard St., 410-576-1414.
* Young People's Health Connection: A city health clinic tailored to teens, 109 Mondawmin Mall, 410-396-0353.
* Baltimore City Health Department, general information, 410-396-4398.
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Side effects associated with the use of Depo-Provera:
* Irregular or unpredictable menstrual bleeding
* Increased appetite and weight gain
* Sore breasts
Source: Pharmacia & Upjohn
Pub Date: 02/22/99