The nation’s leading group of pediatricians has officially endorsed long-acting contraceptives, like intrauterine devices (IUDs), for all teenagers. In a new set of recommendations published this week, the American Academy of Pediatrics (AAP) suggests that doctors should emphasize IUDs as the “first line” of contraception when they’re dealing with their teen patients.
The majority of teens currently rely on condoms as their primary birth control method — but that carries a bigger risk of unintended pregnancy than IUDs, which are considered to be the most effective form of reversible contraception. According to the Centers for Disease Control and Prevention (CDC), long-acting contraceptives have a failure rate of just 0.8 percent. They’re about 20 times more effective than daily regimens like the birth control pill, which women don’t always take as directed, and more than 200 percent more effective than the male condom, which can break.
Experts have long been urging more doctors to encourage their adolescent patients to use IUDs. The AAP’s recommendations come on the heels of a 2012 statement from the American College of Obstetrics and Gynecology that endorsed IUDs for teenagers.
But Americans have been slow to adopt this particular method, thanks to enduring myths that the IUD carries a risk of infertility or infections. There’s also an outdated attitude that this method isn’t safe for women who haven’t yet had kids. On top of that, parents tend to be uncomfortable with the idea that doctors might talk to their teenage children about IUDs, perhaps partly because they’re worried it will give kids more of a license to be sexually promiscuous.
“Parents will always be uncomfortable talking about sex with their children, but I hope we can start moving away from that,” Dr. Sophia Yen, an assistant professor of adolescent health at Stanford Medical School and a member of Physicians for Reproductive Health, told ThinkProgress in an interview. “I hope parents won’t stick their heads in the sand — we know that 30 percent of freshmen in high school have had sex.”
Yen said doctors should be moving toward what she calls “don’t-have-to-think-about-it birth control” that doesn’t require any regular action like remembering to take a pill, fill a prescription, or go to a doctor’s appointment. “What better method for adolescents than one that lasts years, that can get them through high school, college, and grad school?” she pointed out.
The IUD has a proven track record of reducing rates of unintended and teen pregnancy. In Colorado, where a state program provided affordable IUDs for low-income girls, teen births dropped by a dramatic 40 percent over the past five years. A large study in St. Louis found that when low-income teens were given the choice between the full range of birth control methods without being charged a co-pay — the same policy at the heart of Obamacare’s contraceptive mandate — more of them opted for IUDs, and more of them went on to successfully prevent pregnancies and abortions.
Nonetheless, this particular birth control method has remained somewhat politically contentious, as right-wing religious groups incorrectly claim that IUDs are a form of abortion, despite all scientific evidence to the contrary. Earlier this year, craft chain Hobby Lobby went all the way to the Supreme Court to fight for the right to drop coverage for this type of contraception, claiming it violated the evangelical owners’ deeply held opposition to abortion. And now that Hobby Lobby has won its case, it’s paved the way for dozens of other for-profit companies to potentially drop coverage for IUDs, too.
Without insurance coverage for IUDs, this contraceptive isn’t affordable for many Americans, teens or otherwise. The one-time cost of insertion can cost more than $1,000 out of pocket.