Objective: Assess whether uptake of post-abortion contraception varies with time, with changes in insurance regulations, and by demographic characteristics among Massachusetts adolescents. Methods: Retrospective record review of 1,375 minors <=17 years presenting for first lifetime abortion, 2010-2016. Primary outcome: contraception received after surgical abortion, defined as long-acting reversible contraceptive (LARC) (IUD or implant) placed, highly effective contraceptive (HEC) (shot/pill/patch/ring) provided onsite, or no method. Predictors: consent type for abortion (parental vs. court order), race/ethnicity, insurance type, urbanicity of residence, parity, and time in three two-year epochs (7/2010-6/2012; 7/2012-6/2014; 07/2014-06/2016). State-level health insurance reform had been implemented in 2006; the Affordable Care Act’s national contraceptive coverage mandate took effect 7/2012. Multinomial regression estimated relative risk ratios (RRR) for associations. Results: Likelihood of receiving LARC vs. no method increased over time (RRR for second epoch vs. first 1.70, 95% CI 1.21, 2.39; for third epoch vs. first 3.30, 95% CI 2.23, 4.88). Time and HEC were not related. Compared to self-pay, patients using Medicaid (RRR 5.54, 95% CI 3.37, 9.11) or private insurance (RRR 3.91, 95% CI 2.24, 6.84) were more likely to receive LARC. All racial/ethnic minority patients were more likely to receive LARC, but not HEC, compared to non-Hispanic whites (RRR for non-Hispanic Black 1.81, 95% CI 1.13, 2.88; for non-Hispanic Other 1.72, 95% CI 1.10, 2.71; for Hispanic 2.03, 95% CI 1.38, 2.98). Conclusion: Adolescent post-abortion LARC uptake increased markedly over time accounting for demographics and insurance. Racial/ethnic minority adolescents were more likely than non-Hispanic whites to receive LARC.