Pediatricians group supports IUDs, implants for sexually active teen girls

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Teen girls who are having sex should consider long-acting reversible contraception methods such as implants and IUDs as the most effective, safe option for preventing pregnancy, according to the American Academy of Pediatrics, which this week released new policy recommendations for pediatricians.

“Given the efficacy, safety, and ease of use, LARC methods should be considered first-line contraceptive choices for adolescents,” the report says.

Half of high school students in the United States are sexually active, according to the academy.

The report urges pediatricians to do more to educate teens about sexual and reproductive health, and to help teen girls overcome the kinds of barriers that may prevent them from accessing effective contraception – barriers such as cost, parental involvement or stigma around sexual activity, US News and World Report reports.

“We as a society need to work to reduce those barriers and help teens to prevent pregnancy more effectively,” Dr. Eve Espey, former chairwoman of the American College of Obstetricians and Gynecologists’ Committee on Health Care for Underserved Women, told US News.

Cost can be a significant barrier to getting long-acting reversible contraception. An IUD typically costs up to $1,000, according to Planned Parenthood. Implants can cost up to $800.

Under the Afffordable Care Act, most health insurance plans must now cover FDA-approved contraceptives, including IUDs, at no cost to patients.

But, as US News reports, this is not true for every plan.

“Some plans do not yet offer contraception coverage because they are grandfathered plans, meaning they are gradually changing the benefits they provide and will eventually offer the services to comply with Obamacare,” the paper explains.

The academy report says most teens use condoms as their primary method for preventing pregnancy, and the report recommends that teens continue to use condoms in every sexual encounter to prevent sexually-transmitted diseases, along with long-acting or hormonal birth control methods.

The Washington Post reports the new academy policy statement is in line with that of the American College of Obstetricians and Gynecologists, which has recommended since 2012 that doctors encourage teens to use long-acting contraceptive methods.

And, NPR News notes many women’s health groups also support these methods as safe and more effective than other forms of contraception.

Mary A. Ott, who helped write the AAP guidelines, told The Washington Post the growing support of long-acting contraceptives for teens is in part due to a “decade of data suggesting that LARC [methods] are safe in teenagers and they are the most effective tools we have to prevent pregnancy.”

IUDs are more than 99 percent effective at preventing pregnancy and last up to 12 years, according to Planned Parenthood.

Why don’t more doctors recommend IUDs?

Many people have fears and misunderstanding about long-acting devices, stemming from problems in the 1970’s with the Dalkon Shield IUD, which caused pelvic inflammatory disease in many women because of a design flaw, WBUR explains. The flaw has since been fixed and tested for decades.

IUDs (a small T-shaped device inserted into the uterus), implants (inserted into the upper arm) and other long-acting contraceptives are a good fit for teens, Heather Boonstra, Director of Public Policy at the Guttmacher Institute, told WBUR.

“It’s sort of a set-and-forget method,” she tells the station.

CNN cites statistics from Colorado showing the state’s teen birth rate dropped 40 percent between 2009 and 2013, in part due to a program providing long-acting contraception to women who couldn’t afford it. Teen abortion rates also fell by 35 percent.

The $23 million program – funded by an anonymous donor – helped pay for training, outreach and technical assistance to clinics across the state. In 2010 alone, CNN reports, Colorado saved $42 million on health care costs associated with teen births. The program runs until 2015.

The need for more and better contraceptive methods is urgent, The Atlantic reports.

Just over 4 percent of women 15 to 19 years old currently use long-acting birth control, including IUDs, according to the American Congress of Obstetricians and Gynecologists.

And as The Atlantic explains, the U.S. has more teen pregnancies than any other industrialized nation, at a cost of around $11 billion every year, “in the form of public assistance, care for infants more likely to suffer health problems, and income lost as a result of lower educational attainment and reduced earnings among children born to teenage mothers.”

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