Pregnancy Clinical Trial
Official title:
RCT of a Novel Oral Contraceptive Initiation Method
Women who choose to take birth control pills are currently instructed to begin taking the pills at the end of a menstrual cycle. This creates a window of time between when the woman is given the pills and when she begins taking them. Some women fail to begin taking the pills, placing them at increased risk of pregnancy. This study will evaluate a new approach to beginning birth control pills. Women will take the first pill in the doctor’s office rather than waiting until the next menstrual cycle.
Despite the effectiveness of oral contraceptives, pregnancy rates are high among women who
choose this method of birth control. These pregnancies occur due to incorrect use, premature
discontinuation, and failure to begin taking oral contraceptives after they have been
prescribed. As many as 25% of adolescents who seek oral contraceptives from family planning
clinics never take the first pill. Failure to begin oral contraceptives may occur due to
ambivalence, confusion about starting instructions, or intervening pregnancy. Conventional
starting instructions for oral contraceptives require waiting until the next menstrual
period; this may leave the woman at high risk of pregnancy. This trial will evaluate a
"quick start" approach in which the woman swallows the first pill during the clinic visit
under direct observation and then continues daily pill use without waiting for her next
menses. The trial will determine whether immediate oral contraceptive initiation offers
benefits compared to conventional starting approaches.
Participants in this study will be randomized to receive either the quick start or the
standard starting approach. Participants will complete a questionnaire at study entry and
Months 3 and 6. The main outcomes are 6-month oral contraceptive continuation rates and
pregnancy rates.
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Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Factorial Assignment, Masking: Open Label, Primary Purpose: Prevention
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