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 Only about 5 percent of teen girls in the U.S. use long-acting
reversible contraception (LARC) methods like intrauterine devices
(IUDs) and hormonal implants, often opting instead for birth control
pills or condoms, according to the authors of the study.
“What we know is that IUDs and implants . . . are the most effective
types of birth control available for teens,” said Dr. Lisa Romero, a
health scientist at the Centers for Disease Control and Prevention
in Atlanta, Georgia, who led the study.
“We also know LARC is safe for teens, easy to use and highly
effective,” Romero told Reuters Health. Less than 1 percent of women
who use IUDs or implants become pregnant in the first year they are
used, she said.
More than 273,000 infants were born to U.S. teens ages 15 to 19 in
2013, according to the CDC. Giving birth can lead to health,
economic and social problems for these young mothers and their
children, and costs the U.S. $9.4 billion yearly, Romero and her
colleagues write in the CDC Morbidity and Mortality Weekly Report.
The study team analyzed use of long-acting contraceptives by 15 to
19 year olds between 2005 and 2013 at 4,200 Title X Family Planning
Clinics. The clinics provide free or low-cost contraception,
screening for sexually transmitted diseases, HIV testing and
cervical cancer screening for low-income people.
Over that time period, 7.5 million teen girls were seen at the
centers, and their use of LARC rose 15-fold, from 0.4 percent in
2005 to 7.1 percent in 2013.
Still, the percentage remains low, researchers point out, and varies
widely among states. In the most recent year examined, LARC use
ranged from 0.7 percent of teens in Mississippi to nearly 26 percent
in Colorado, they found.
Training clinic staff on how to insert the devices and counseling
girls on the safety and benefits of these methods, as well as making
the birth control affordable, helped increase the number of users,
according to the analysis.
“We know use of LARC among teens is low because of existing
barriers, including awareness, access and availability,” Romero
said.
She added that teens might mistakenly think their age is a barrier
to being able to use LARC methods and health care providers might
not supply the contraceptives because of the cost, safety concerns,
lack of training on insertion and removal or knowledge of the
counseling needed for teens who do opt for these methods.
In the 1970s, the Dalkon Shield (IUD) was associated with pelvic
infections and pulled from the market, although current IUDs are
designed differently and are generally considered safe.
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“They are safe, and some offer other benefits, such as making
periods lighter and less painful. These methods are also
low-maintenance, since they are used for three to 10 years after
placement,” said Dr. Jessica Kiley, an obstetrician-gynecologist who
specializes in contraception and family planning but was not
involved in the study.
“It is reassuring that we are seeing both increased long-acting
reversible contraception (LARC) use and decreased teen pregnancy
rates, but the latter remains a critical public health issue,” said
Kiley, of Northwestern Medicine in Chicago. “Efforts to further
reduce the rate must continue.”
Romero said possible side effects of IUDs include changes in
menstrual pattern and cramping and pain right after insertion.
Implants can also be associated with menstrual changes and possible
weight gain.
IUDs cost more than $800 and last about five years, implants cost
$800 over three years, and oral contraceptives go for about $720 per
year, Romero said.
Various national health organizations support LARC use for teens and
other women, Romero noted. The CDC, American Academy of Pediatrics
and American College of Obstetricians and Gynecologists all think
LARC should be discussed as possible options.
“Women and society benefit when young people make active decisions
about their own fertility and reproduction,” Kiley said in an email
to Reuters Health. “Improved access to contraception allows young
women to finish schooling, earn degrees and care for their families
better.”
No outside funding was used for the CDC analysis, which was part of
a National Family Planning annual report, according to Romero.
SOURCE: http://1.usa.gov/1OCMtVE
Morbidity and Mortality Weekly Report, April 10, 2105.
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