of hospitalization, medication tolerance, and venous thromboembolism (VTE) among study groups. We hypothesize compared with either intra- venous (IV estrogen) or combination oral contraceptives (COC) alone, the addition of tranexamic acid to oral contraceptives is associated with decreased length of stay and improved tolerance, and there is no difference in incidence of thromboembolic events. An IRB-approved retrospective cohort study was performed of female adolescents age 9 to 20 hospitalized from 2003 to 2017 at a large pediatric institution for treatment of heavy uterine bleeding. Descriptive statistics were reported in addition to one- way ANOVA or Kruskal-Wallis tests for continuous variables and Chi- square or Fisher’s exact tests for categorical variables with two-sided p- values and a significant level of 0.05. Results: Two hundred and eighty one charts were identified, and after excluding pregnant patients and those refusing research participation, there were 118 patients hospitalized for heavy uterine bleeding. Thirty- two received treatment other than the target treatments, 21 received COC, 14 received IV estrogen with or without COC, and 51 received TXA with COC. There was a significant association between treatment group and year of admission (p<0.001), and after 2010, more patients received TXA and no patients received IV estrogen. Compared to IV estrogen, signifi- cantly fewer patients receiving COC or TXA with COC required anti-emetics (p 0.020). No difference was seen between COC and TXA with COC (p 0.068). There was no difference in length of stay, hemoglobin on admis- sion, or need for blood transfusion. There were two readmissions for bleeding or anemia, both in the COC group. There were no readmissions for VTE in target treatment groups, but one patient with solo agent TXA had a pulmonary embolism 60 days after admission. Conclusions: There is wide variation in treatment regimens for adoles- cents with heavy uterine bleeding requiring hospitalization. Length of stay was similar regardless or treatment group, IV estrogen had the highest need for anti-emetics, and there was no difference in VTE. With this retrospective data as a platform for a prospective study, we hope to contribute to the currently limited literature on TXA for adolescents hos- pitalized with heavy uterine bleeding. Ă Ă 25. LARCs: Does the Specialty Training of the Inserting Provider Impact Complication and Discontinuation Rates? Keisha Adams, Pippa Simpson, Jody Barbeau, Mingen Feng, Seema Menon Medical College of Wisconsin This work has been previously published. 26. The Impact of Commitment to Postpartum Contraception During Antepartum Period in the Adolescent Population Sarah Fausel, Olivia Winfrey, Jenna Yamamoto, Wendy Jackson University of Kentucky Background: Long-acting reversible contraception (LARC) is an effective method of postpartum contraception in the adolescent age group. Con- traceptive counseling is a priority, including a prenatal commitment to postpartum contraception. This study assesses the impact of prenatal contraceptive counseling on choice of postpartum contraception among adolescents in a dedicated adolescent pregnancy clinic versus other clinics that serve all women. Methods: A retrospective chart review was conducted of all pregnant patients  21 years of age who delivered at University of Kentucky (UK) Hospital between July 1, 2018 and June 30, 2019. These patients had at least 1 prenatal visit at a clinic within the UK system on the main campus in Lexington, KY. Patients were seen at one of four clinics: (1) Young Parents Program (YPP), for patients aged  21 years, staffed by residents super- vised by a faculty member trained in pediatric and adolescent gynecology; (2) Generalist, staffed by 8 faculty physicians and a nurse practitioner; (3) Polk Dalton, staffed by residents supervised by generalist faculty; and (4) MFM, for high-risk patients, staffed by residents or a nurse practitioner under MFM faculty supervision or MFM faculty alone. Demographic and clinical variables including age, clinic type, prenatal contraceptive coun- seling, and choice of contraception were abstracted from the electronic medical record. The primary outcome measure was commitment to postpartum contraception during the prenatal period. Data were analyzed using SPSS. Chi square test of independence was used. Results: There were 126 patients with age ranging from 14-21 (mean 19.3) years. Distribution of prenatal care by clinic was as follows: Polk Dalton (n¼45, 35.7%), MFM (n¼31, 24.6%), YPP (n¼26, 20.6%), and Generalist (n¼24, 19.0%). Most patients received contraceptive counseling at a prenatal visit (n¼108, 85.7%). Of these patients, 61 (56.5%) committed. There was a trend of prenatal commitment to contraception by clinic type with 18/25 (72%) of YPP patients committing compared to 3/10 (30%), 26/44 (59.1%), and 14/29 (48.3%) in the other clinics, respectively. This trend was not sta- tistically significant (p¼0.1). Patient commitment to contraception during prenatal care was significantly associated with method chosen at post- partum visit (p¼0.03). Of the 33 patients who committed to LARC and presented for the 6-week postpartum visit, 24 (72.7%) chose LARC. Conclusions: Many patients receive contraceptive counseling during routine prenatal care, but gaining a commitment is not as prevalent. A dedicated adolescent pregnancy clinic is well-equipped to emphasize the importance of choosing a contraceptive. Committing to contraception prenatally leads to follow-through in the postpartum period. 27. Postpartum Long-Acting Reversible Contraception (LARC) Use in the Adolescent: The Role of Dedicated Adolescent Pregnancy Clinics Olivia Winfrey, Sarah Fausel, Jenna Yamamoto, Wendy Jackson University of Kentucky Background: Per CDC data, teen birth rates have declined about 40% from 2006 to 2014, though there are regional disparities present. Higher rates, particularly in the southern United States, have prompted the cre- ation of dedicated pregnancy clinics for adolescents. Highly effective postpartum contraception is a priority for these clinics. Long-acting reversible contraception (LARC) has been shown to be an effective method in this age group. This study compares postpartum LARC use among ad- olescents in a dedicated adolescent pregnancy clinic versus other clinics that serve all reproductive age women. Methods: A retrospective chart review was conducted of all pregnant patients  21 years of age who delivered at University of Kentucky (UK) Hospital between July 1, 2018 and June 30, 2019. These patients had at least Poster Presentation Abstracts / J Pediatr Adolesc Gynecol 33 (2020) 177e211 188