The nation s most influential pediatricians group, the American Academy of Pediatrics (AAP), recently updated their recommendations for teen pregnancy prevention. The updated policy statement and accompanying technical report published in Pediatrics on September 29th state that sexually active teen girls should use IUDs (intrauterine devices) or hormonal implants. These contraceptives are known as Long Acting Reversible Contraceptives (LARCs). The AAP states that their new guidelines are based on evidence throughout the past decade demonstrating that LARCs are safe for adolescents.
According to the American College of Obstetricians and Gynecologists, 42 percent of adolescents aged 15-19 years have had sexual intercourse. While most sexually active teens report using some method of contraception during their lifetime, the methods they use are usually condoms, withdrawal, or oral contraceptive pills. All of these methods have relatively high typical use failure rates. While oral contraceptives can be over 99 percent effective, this effectiveness is only if the pill is always taken every day as directed which few women actually do. In fact, the Guttmacher Institute reports that with typical use (taking into account when users fail to take pills consistently or correctly), oral contraceptives are only 91 percent effective.
IUDs and hormonal implants, on the other hand, are inserted into the womb during a medical procedure, and keep working for years IUDs typically work for three to ten years after insertion, while implants typically work for three years. With typical use, IUDs are 99.8% effective. Because IUDs and hormonal implants are inserted through a medical procedure, they usually cost hundreds of dollars but are less expensive in the long-run than condoms or prescription birth control pills.
The policy emphasizes that abstinence is 100% effective at preventing pregnancy and STDs, and should be encouraged by pediatricians. However, because many teens do not heed this advice, pediatricians should also provide birth control guidance good advice, considering 82 percent of adolescent pregnancies are unplanned, accounting for 20 percent of all unintended pregnancies in the US. The policy also encourages condom use every time teens have sex, as birth control pills, IUDs, and hormonal implants do not provide protection against STDs.
ACSH s Dr. Gil Ross added this comment: The AAP advisory comes at a most opportune time, since the current New England Journal of Medicine has a new study showing an astounding 75 percent reduction in expected rate of unplanned teen pregnancy among 1400 teens in a poorer area of St. Louis. The researchers, from Washington University-Barnes Hospital, offered free LARCs to a larger group, and 72 percent elected either IUD or implant (LARC) for birth control (unlike in general clinical practice, for the study parental consent was required). The LARC group had one-quarter the risk of pregnancy as compared to the statistical norm among all U.S. teens. This clearly supports the use of these methods, and starkly illustrates why American teens have one of the highest rates of teen pregnancy and abortion in the developed world: abstinence-only fails way too often, and unfortunately so do the commoner methods such as condoms and OCs.
