Roosevelt Institute | Cornell University

A Push for Long-Acting Contraception

By Anna GrosshansPublished October 21, 2014

Recent studies have shown that long-acting contraceptives are both safe and highly effective. Policy reforms incorporating these findings will better enable young women to achieve their educational and life goals.
By Anna Grosshans, 10/21/2014

At 16 years old, she was pregnant and scared.  "I didn't want to make the same mistake as my mom," she told me.  She's not alone; currently, almost one in three women in the United States becomes pregnant before the age of 20, a much higher rate than other wealthy nations.   

 But there's good news: A recent five-year effort to provide long-acting contraceptives to young women in St. Louis cut the teen pregnancy rate by 79 percent and the abortion rate by 77 percent, according to a new study.  The report in the October 2nd New England Journal of Medicine comes from the St. Louis Contraceptive CHOICE Project, which provided 1,404 young women between the ages of 14 and 19 with long-acting contraceptives at no cost.

 Currently, almost one in three women in the United States becomes pregnant before the age of 20, a much higher rate than other wealthy nations.  Physicians and public health officials are optimistic that the results of this study could be replicated on a national scale to lower the rate of unintended pregnancies among young women. 

 Until recently, doctors recommended long-acting contraceptives primarily for women who had already had a child, but these new findings suggest that they are safe and beneficial for young women without children as well.

 Long-acting contraceptives include intrauterine devices (IUDs) and implants.  Experts now recommend long-acting contraceptives over more popular methods, including the Pill, because they have much lower failure rates.  The Pill is the most common form of contraception in the United States, yet 9 out of every 100 women using the Pill become pregnant each year.  This high rate of failure is a result of incorrect and inconsistent use, such as skipping a day and forgetting to start a new pack on time. 

Long-acting contraceptives eliminate the risk of making a mistake that could result in an unintended pregnancy.  Once they are in place, they require little to no attention for up to twelve years, depending on the method.  Although they remain effective for years, a physician can remove them quickly and easily at any point.

Another project to provide young women with long-acting contraception produced similar results in Colorado from 2009 to 2013.  The program provided 30,000 women with long-acting contraception and led to a 40 percent decrease in the teen birth rate in Colorado.

The drop in teen birth rates generated a ripple effect, leading to lower abortion rates, reduced enrollment in infant nutrition programs, and an overall $42.5 million decrease in spending on healthcare costs related to teen births.

 In both studies, almost 75 percent of participants that received comprehensive information about birth control options chose long-acting methods.  Only 8 percent of contraceptive users in the United States currently use long-acting methods.

 "With organizations like the American Academy of Pediatrics encouraging doctors to recommend LARCs for sexually-active teens through their new guidelines, we should see more young women seeking these very effective forms of birth control," said Debby D'Arcangelo, President and CEO of Planned Parenthood of the Mercer Area. 

 "The effectiveness of these contraceptives combined with the fact that they may be obtained with no out-of-pocket costs through the Affordable Care Act means that they can have a significant impact in terms of preventing unintended pregnancies and helping young women achieve their education and life goals," said D'Arcangelo.