Long- term birth control called best for teenagers

IUDS and implants are effective methods, pediatricians say.

To prevent teen pregnancies, pediatricians should talk with their adolescent patients about birth control, starting with hormonal implants and IUDs, according to an updated policy statement from the American Academy of Pediatrics.

Progestin implants and intrauterine devices are not widely used by teens, but they are the most effective methods of contraception available. Only 1 in 2,000 women using progestin implants has an unintended pregnancy during the first year of use. Depending on the type of IUD, the rate of accidental pregnancy ranges from 1 in 125 to 1 in 500.

Nearly half of all teens are sexually active during high school, and about 750,000 young women become pregnant each year, federal data show. “More than 80% of these pregnancies [ are] unplanned, indicating an unmet need for effective contraception in this population,” an expert panel wrote in the policy statement published lastweek.

Condoms are the most common form of birth control among teens, with 52% of young women and 75% of young men reporting their use, according to the National Survey of Family Growth, an ongoing study conducted by the Centers for Disease Control and Prevention.

Condoms are important for preventing the spread of sexually transmitted infections, or STIs, but they are not nearly as effective at preventing pregnancy. According to the policy statement, 18% of women who start using condoms for birth control become pregnant within one year.

In discussing birth control with their patients, pediatricians should encourage teens to abstain from sex if they are not emotionally ready for it, the panel wrote. “Abstinence is 100% effective in preventing pregnancy and STIs,” the statement reads. “However, existing data suggest that, over time, perfect adherence to abstinence is low ( i. e., many adolescents planning on abstinence do not remain abstinent). Therefore, pediatricians should not rely on abstinence counseling alone.”

As much as possible, the decision about whether to use contraception should be made by patients, not dictated by their parents, the academy advises.

In addition, doctors should do as much as they can to protect the confidentiality of their underage patients.

Twenty states have limits on allowing minors to consent to using birth control, according to the Guttmacher Institute. ( Most other states and the District of Columbia allow minors to make their own decisions regarding contraception, and four states have no laws on the books that would restrict them from doing so.)