Contraception for Adolescents

Teenage pregnancy rates in the USA have declined for over 20 years, primarily due to increased access to highly effective contraceptive methods. Despite these encouraging trends, US teen pregnancy rates still remain higher than most other developed nations. There are significant medical, psychological, and financial implications and morbidities associated with unintended teen pregnancy and thus primary prevention strategies to decrease rates of teen pregnancy should be a focus for clinicians. New data shows significant benefit of long-acting reversible contraception (LARC)—intrauterine devices or subdermal implants—over shorter acting methods such as the birth control pill. Despite these data, along with policies from the American College of Obstetricians and Gynecologists and the American Academy of Pediatrics supporting provision of LARC to adolescents, there is a lag among clinicians to communicate this information to their adolescent patients as standard of care. Many providers continue to utilize only short-acting methods such as the pill. Until clinicians more comprehensively adopt use of LARC methods as first-line agents for teenagers, rates of unintended pregnancy within this age group will likely remain high. Working to recognize and decrease barriers to contraceptive access should be a public health priority.