Why Adolescents Should Consider Using Long Acting Reversible Contraceptives

Caitlin Callahan is the Co-Coordinator of the New York City IUD Taskforce and Anna Falkovich is currently completing her MPH Practicum at Public Health Solutions. 
 
Long acting reversible contraceptives (LARCs) – specifically, intrauterine devices (IUDs) – are effective, safe, affordable, and low-maintenance, and the public health community has finally taken notice. For decades, the IUD was only considered an appropriate form of contraception for older, post-child-bearing women. However, with newer IUDs and guidance from standards-setting bodies like the ACOG and the WHO, the IUD has gained popularity among U.S. contracepting women of all ages, including adolescents. Between 2002 and 2009, the IUD usage rate among contracepting American women increased from 2% to 7.7%. For teens, the IUD usage rate increased from 1.5% to 4.5%. However, compared to the global IUD usage rate of 22.6%, American women are late to the party. 
 
There are many reasons why IUDs are the preferred method for an increasing number of adolescents:
 
IUDs are Effective. The pill has a failure rate of 9%. The IUD boasts a remarkable failure rate of less than 1%, winning over the pill hands down. 
 
IUDs Require Minimal Maintenance. Aside from regular provider check-ins and the use of a condom as protection against sexually transmitted infections, the IUD may remain in place for up to 10 years. If a woman decides to remove her IUD, she may visit her provider for an easy procedure. No daily pills to take, no prescription renewals. 
 
IUDs are Safe. Complications are rare, and research has shown that infertility after an IUD is not more likely than after another contraceptive methodl. 
 
IUDs are Cost-Effective and Affordable. The IUD is more expensive than other methods, but it is a one-time cost, and cost-sharing regulations under the Affordable Care Act mandate that every insurance plan must cover the device and any associated costs. 
 
IUDs Can Regulate Periods. IUDs can change a woman's cycle through hormonal or non-hormonal means, helping her regulate the duration and frequency of her period.
 
Adolescents, however, continue to experience a variety of barriers to accessing IUDs. Many providers rely on outdated guidance, or lack training for insertion/removal of IUDs. Additionally, many are unaware of the IUD's potential benefits and that it is an appropriate option for their younger patients. Myths exist about the device's safety and side effects, especially among older generations; teens might feel pressure from their parents to avoid IUDs. 
 
So what can the public health community do to address these barriers? One movement has already started in New York City: a coalition of providers, researchers, advocates, and other public health professionals have joined to form the New York City IUD Taskforce. The Taskforce seeks to address the systemic limitations (financial, institutional, legal, and educational) that may hinder knowledge, awareness, access, and use of contraceptives, specifically highly-effective LARCs. The Taskforce has facilitated trainings to increase the number of trained providers offering IUDs in New York City; written policy briefs; developed patient education materials and showcased a provider directory to promote greater access among contracepting women. The Taskforce's newest project, the IUD Community of Practice, elevates this conversation to a national level and generates greater communication and collaboration among champions in this field. If you are interested in learning more, we invite you to join this community.
 
Adolescents should be informed about all of the different types of contraception available in order to make decisions about what is best for their own bodies. To protect women's rights to full contraceptive choice and ensure that all women who choose an IUD can have one, we must continue to promote awareness for this method and break down the barriers.  
 
For more information about IUDs or to find a provider near you, visit IUDTaskforce.org