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Fewer teens are having babies than in years past, but most American teenagers are still not using the best methods of birth control, federal health experts said Tuesday. And that’s one big reason why the U.S. teenage birth rate is still seven times higher than rates in other rich countries.
It’s up to the doctors and other health experts who see teenagers to let them know about the safest and most effective methods, the Centers for Disease Control and Prevention says. And that means IUDs (intrauterine devices) and implantable birth control.
“We have the opportunity to provide our teens with complete and accurate health information … so that they can make healthy and good decisions about preventing pregnancy,” CDC Principal Deputy Director Ileana Arias told reporters in a telephone briefing.
"During the first year of typical use, both IUDs and implants have lower failure rates than oral contraceptives and condoms.”
The latest data shows that many teenagers are still having babies.
“The teen birth rate in the United States has continued to decline during the past two decades, from 61.8 births per 1,000 teens aged 15–19 years in 1991 to an all-time low of 26.5 births per 1,000 teens in 2013,” CDC says.
“Improved contraceptive use has contributed substantially to this decline; however, there were approximately 273,000 births to teens in 2013, and the U.S. teen pregnancy rate remains up to seven times higher than in some developed countries.”
According to the National Bureau of Economic Research, the teen birth rate in Switzerland was 4.3 births per 1,000 teen women; in Britain it was 25 per 1,000.
The CDC team looked at what kind of birth control teenagers aged 15 to 19 were getting from family clinics funded by the federal Title 10 program.
“Use of long-acting reversible contraception among teens seeking birth control services increased from less than one percent to seven percent from 2005 to 2013,” they wrote in the CDC’s report.
In 2005, just 0.4 percent of teens were getting implants or IUDs. By 2013, more than 7 percent were. “Of the 616,148 female teens seeking contraceptive services in 2013, 17,349 (2.8 percent) used IUDs, and 26,347 (4.3 percent) used implants,” the report reads.
That’s even though these methods are far more effective than condoms, the most favored birth control device, and very safe.
"Long-acting, reversible contraception requires no effort after insertion, and can prevent unintended pregnancy for at least 3 to 10 years,” the CDC team said.
“During the first year of typical use, both IUDs and implants have lower failure rates (less than one percent) than oral contraceptives (9 percent) and condoms (18 percent).”
There were huge variations from state to state.
In Colorado, 25.8 percent of teens treated at these clinics got implants or IUDs. Nearly 20 percent of Alaska teens did and 18 percent in Washington, D.C. “The lowest percentage of teen clients using long acting reversible contraception was in West Virginia (2 percent), Indiana (1.5 percent), and Mississippi (0.7 percent),” CDC said.
“They might feel a little bit more squeamish about insertion and removal of an IUD."
The CDC’s Dr. Lee Warner says Colorado has embraced recommendations to encourage teenagers to use these more effective methods. Just last year, the American Academy of Pediatrics said teenagers need to be told about the most effective birth control methods.
And the American College of Obstetricians and Gynecologists (ACOG) embraces these recommendations, too.
“Long-acting reversible contraceptive (LARC) methods — including intrauterine devices (IUDs) and implants — are the most effective forms of reversible contraception available and are safe for use by almost all reproductive-age women. We firmly believe that increased adoption of these methods can play a role in reducing unintended pregnancy,” ACOG CEO Dr. Hal Lawrence said in a statement.
These methods cost more money up front and teenagers have to get past the “ick” factor, said Warner.
“Younger teens might find the IUD to be a little more invasive,” Warner said.
“They might feel a little bit more squeamish about insertion and removal of an IUD,” Arias agreed.
As for implants, teenagers might worry that parents or friends might see them, Warner noted.
The CDC notes that many Americans would prefer that teens do not have sex at all. “Health professionals can encourage teens to not have sex,” Arias said.
But the reality is that they do, and they need to use effective contraception as well as condoms to protect them from sexually transmitted diseases, the CDC says.