Providing teenage girls with affordable access to long-lasting contraception, like intrauterine devices (IUDs), can cut their rates of unintended pregnancy and abortion by more than 75 percent, according to a new study published in the New England Journal of Medicine on Wednesday. The data suggests that teens can effectively prevent pregnancy when they’re educated about their full range of sexual health options.
The results come from a large research project, called the Contraceptive CHOICE study, being conducted in St. Louis. Researchers there are studying the impact of providing a group of low-income women with the birth control method of their choice free of charge, which is the same policy at the heart of the health law’s contraception mandate.
The latest data was derived from tracking a group of 1,404 teen girls enrolled in the Contraceptive CHOICE project, the vast majority of whom were already sexually active and at particular risk for unintended pregnancy. After those girls received counseling about their different birth control options, and were given a chance to select any method free of charge, 72 percent of the group opted for an IUD or an implant, which are more effective methods because they involve less user error. That’s dramatically higher than the national rate of teen IUD use, which currently hovers around five percent.
And after that, researchers observed a significant decline in the pregnancy, birth, and abortion rates among those teens. While sexually experienced U.S. teens have an annual pregnancy rate of 158.5 per 1000, for instance, that rate was just 34 per 1000 among the teen participants in the CHOICE project.
Altogether, over five years, researchers observed that the pregnancy rate dropped by 79 percent and the abortion rate declined by 77 percent for the girls who participated in their study. Plus, while African American teens have a higher unintended pregnancy rate than white teens nationwide, that racial disparity virtually disappeared in the CHOICE project.
Experts are hailing the “landmark” results, which come just a few days after the American Academy of Pediatrics officially endorsed IUDs as the “first line” of contraception that doctors should recommend to teens. Two years ago, the American College of Obstetrics and Gynecology took the same position.
“If we provide great contraceptive care and access to all of our teens in the U.S., this is what we could see,” Gina Secura, the lead author of the study and a senior epidemiologist at the Washington University School of Medicine, told Al Jazeera. “We are still in a country where it just makes us skeevy to talk about sex, especially with young folks. It’s a real bummer because we actually have a medical intervention that will work, and we just need to be better about talking about it.”
Previous research has found that parents tend to be uncomfortable with the idea that doctors might recommend IUDs to their teenage children, perhaps partly because they’re worried it will give kids more of a license to be sexually promiscuous. That’s the same attitude that has fueled the resistance to other policies that could effectively prevent teen pregnancies, like implementing comprehensive sex ed across the country. While researchers recommend that sexual health classes should start as early as age 10, many public school districts still resist any efforts to move away from “abstinence-only” courses that tell kids having sex will make them dirty.
Doctors are optimistic about move toward IUDs — the number of teens using them tripled between 2007 and 2009 — and hope the trend will continue. State-level programs that have expanded teens’ access to IUDs have seen similarly encouraging results as the CHOICE project. In Colorado, teen births have dropped by 40 percent over the past five years for this reason.
But without insurance coverage, cost can be a barrier; IUDs can be more than $1,000 upon insertion. Although the health care reform law eliminates that cost, craft chain Hobby Lobby’s recent win at the Supreme Court has given other companies an opening to try to drop coverage for this particular type of birth control.