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Pediatricians now recommend IUDs over the pill for teen birth control


Intra-uterine devices — small, T-shaped devices that doctors implant in a woman's uterus — are one of the most effective forms of birth control. And pediatricians want more teenagers using the long-acting contraceptive, largely because it leaves little room for error.

In new recommendations published Monday, the American Academy of Pediatricians endorsed implantable birth control as "first-line contraceptive choices for adolescents." The group recommends that pediatricians either learn how to implant these devices or identify health care providers in their communities to whom patients can be referred."

These recommendations put the pediatricians in line with the American College of Obstetricians and Gynecologists, which has recommended long-acting, reversible birth control as the first-line choice for teenagers since 2005.

Teen IUD use still small, but rising

Since the American College of Obstetricians and Gynecologists guideline came out, more teenagers have gravitated toward the the long-acting contraceptive. In 2002, an almost-negligible 0.3 percent of teenagers used IUDs. In 2009, the most recent year for which data is available, 4.5 percent of women between 15 and 19 were using the device.


Experts argue that this rise in IUDs is likely partially responsible for the recent steep decline in teen birth rates. Implantable birth control requires no work on the part of the patient after a doctor inserts the device. Birth control pills and patches - which have to be taken or applied at regular intervals - leave significant space for user error.

The copper IUD, for example, has a failure rate of 0.8 percent - meaning that for 1,000 women using IUDs, approximately eight would get pregnant per year. Birth control pills, meanwhile, have a failure rate of 9 percent, more than ten times the rate of most IUDs.

IUD use has proven to be incredibly effective in small experiments to control teen pregnancy. For example, when a Colorado program made the contraceptives available at no cost to low-income teens, it led to a 40 percent drop in birth rates over four years.

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