Adolescentsʹ compliance with return visits for depot medroxyprogesterone initiation

Study objective To determine if and when female adolescents choosing depot medroxyprogesterone would return for a second visit for initiation of the method. Design/setting Retrospective chart review at an adolescent clinic in an urban health department in St. Louis, MO. Participants Female adolescents aged 12–19 years old, at the initial or annual family planning visit, who chose depot medroxyprogesterone (DMPA) as their contraceptive choice but were unable to get the initial injection on the day of the visit. Main outcome measure Time to return visit. Results A total of 144 subjects were included in the analysis. 92% or 133 subjects returned for a second visit. The average time to return visit was over 3 months, or 104 days (range 1–650 days). Teens who returned in less than 1 month were more likely to receive a hormonal contraceptive method. Only 68% of all returning teens received DMPA while 7% became pregnant prior to their return. Conclusions Protocols requiring a second visit for initiation of DMPA serve as a barrier to contraceptive care.