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Starting oral contraceptives immediately or during next menses did not differ for continued contraceptive use or pregnancy at 6 months

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C Westhoff

Correspondence to: Dr C Westhoff, 630 West 168 St, New York, NY, USA; clw3@columbia.edu

QUESTION

In young women, does directly observed, immediate initiation of oral contraceptives (OCs) increase continuation rates and reduce pregnancy compared with standard delayed initiation (during next menses)?

METHODS

Design:

randomised controlled trial.

Allocation:

{concealed}.*

Blinding:

unblinded.

Follow-up period:

3 and 6 months.

Setting:

3 urban family planning clinics in Atlanta, New York, and Dallas, USA.

Patients:

1720 women <25 years of age who were sexually active, requesting OCs, and had a current negative pregnancy test. Exclusion criteria were use of OCs within 7 days or Depo-Provera within 6 months, desire for pregnancy within the next 6 months, lactational amenorrhoea, or women <18 years of age who were postpartum or postabortion.

Intervention:

864 women were allocated to the Quick Start group. During the initial clinic visit, they opened the OC …

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