Which Birth Control Methods Are Best for Teens?

Sept. 21, 2012 -- Sexually active teen girls' best bet for birth control is either an IUD or a birth-control implant, say new guidelines from a leading doctors' group.

More than 40% of teens are sexually active. Nearly all of them use some kind of birth control. But fewer than 1 in 20 uses the most effective contraceptives.

The result: 82% of teen pregnancies are unplanned.

"Intrauterine devices and the [birth-control] implant are the best reversible methods for preventing unintended pregnancy, rapid repeat pregnancy, and abortion in young women," state the new guidelines from the American College of Obstetricians and Gynecologists (ACOG).

Condoms and birth-control pills work very well if used exactly right. The way most people use them, however, they often fail. Condoms put on wrong or lubricated too little can break. And missing even one dose of a birth-control pill, or even taking one at the wrong time of day, raises the chance of failure.

These common forms of birth control are even more likely to fail in the hands of teens. On the other hand, IUDs and birth-control implants work extremely well -- and work just as well in teens as in adult women.

IUD vs. Birth-Control Implant

An IUD is a device shaped like the letter "T." Once inserted into the uterus -- a procedure that can be uncomfortable -- it prevents pregnancy for up to 12 years. It can be removed whenever a woman wants.

Getting an IUD can cost between $500 and $1,000. It must be placed by a health care professional.

Birth-control implants are rods the size of a matchstick inserted into the arm. They last up to three years, and can be removed whenever a woman wants.

Getting a birth-control implant costs $400 to $800. It must be placed by a health care professional.

Health Care Pros Advised to Help Teens Get IUDs, Implants

The guidelines state that it's up to the teen to decide whether she wants to get an IUD or a birth-control implant or not.

"Health care providers should consider long-acting reversible contraception methods for adolescents and help make these methods accessible to them," the guidelines say.

The guidelines also state that health professionals should protect teens' confidentiality, which "is of particular importance to adolescents."

As of September 2012, in 21 states and the District of Columbia, nobody other than the teen needs to be involved in the decision. In 25 states, laws restrict the ability of teens to decide all by themselves:

• Twenty-one states allow teens to consent to birth control services if they are married.
• Three states allow minors to consent to birth control services if a doctor determines they would face a health hazard without them.
• Six states allow minors to consent to birth control services if they already are parents.
• Six states allow minors to consent to birth control services if they are or have ever been pregnant.
• Eleven states allow minors to consent to birth control services if they meet requirements such as having a high school diploma, demonstrating maturity, or receiving a referral from a doctor or member of the clergy.

The ACOG guidelines note that cost will be a barrier to teens who, to protect their confidentiality, do not want to seek benefits under their parents' health insurance. Other teens' family health insurance may not cover birth control, or they may be uninsured.

"In all of these cases, referral to a publicly funded clinic may be appropriate," the guidelines suggest. "Proposed health care reform methods, including [IUDs and birth-control implants], without co-payments or deductibles for these preventive health services, may ease this burden."

The new ACOG guidelines appear in the October issue of Obstetrics & Gynecology.