Contraceptive counselling in regions of Victoria with high incidence of teenage pregnancy: general practitioners' insights.

Abstract

Background Certain regions of Australia have a higher incidence of teenage pregnancy compared to the national average. In Australia, general practitioners (GPs) are the first-line providers of contraception information and provision. However, little is known regarding GP provision of contraceptive counselling among teenagers and whether they are offering teenagers long-acting reversible contraceptive methods. We aimed to obtain GPs' insights into how they approach contraceptive counselling with teenagers in regions of Victoria, Australia, with a high incidence of teenage pregnancy. Methods We conducted a qualitative descriptive study using semi-structured telephone interviews with GPs purposively sampled from regions of Victoria, Australia, with high incidence of teenage pregnancy. Interview data were analysed using a reflexive thematic analysis approach. Results The 18 GPs interviewed recognised there was an unmet need for contraception information and care among teenagers in their region. Most felt that teenagers in their region had limited knowledge of and access to contraception, due in part to the lower socioeconomic status of the community, associated costs, and limited providers available to insert long-acting reversible contraceptives. Participants' approaches to providing contraceptive counselling varied; however, most provided this opportunistically. Although they reported discussing all contraceptive options with teenagers, most were less inclined to recommend an intrauterine device (IUD). The primary reasons for this included concerns regarding suitability of IUDs for younger or nulliparous people and limited providers able to insert IUDs in their region. Participants described the importance of normalising contraception discussions to facilitate contraceptive counselling and decision-making. Conclusion Supporting informed decision-making and facilitating access to all methods of contraception for teenagers will require addressing misunderstandings among GPs regarding IUD suitability for teenage and nulliparous people and increasing the number of IUD-inserting GPs. Discussing contraception as part of routine care for teenagers will further support these endeavours.