Long-acting reversible contraception, such as intrauterine devices (IUDs) and progestin implants, should be the first choice for teens when it comes to birth control, according to new guidelines from the American Academy of Pediatrics.

For the first time, AAP recommends that pediatricians discuss long-acting, reversible contraception before other birth control methods for teens, citing the "efficacy, safety and ease of use" of LARC.

The organization also recommends that pediatricians encourage using condoms for every sexual act, which reduces the risk of sexually-transmitted diseases.

These guidelines are backed up by a new study which says IUDs and implants could cut pregnancy rates by almost 80 percent in sexually active teens.

Researchers studied 1,404 teenagers who were offered free birth control of their choice. A majority chose LARC, such as IUD or implant.

After three years, their pregnancy rate was 3.4 percent, compared with almost 16 percent in the general sexually active teen population, ABC News reported.

IUDs are small, T-shaped devices which are inserted into the uterus by a doctor. An IUDh can prevent pregnancy for up to 10 years with a failure rate of about 0.8 percent, according to the Centers for Disease Control and Prevention.

Implants, which are thin rods inserted under the skin on the upper arm, release progestin and last for about three years, with a failure rate of 0.05 percent.

Both methods require more interaction with doctors than other commonly used birth control methods, such as condoms.

High condom use is partly due to cost and the ease of access. Cost and access to doctors can make it more challenging for teens to use LARC methods, Dr. Mary Ott, an adolescent medicine specialist at Indiana University and lead author of the AAP guidelines acknowledged to the Washington Post.

In addition, Ott told LiveScience.com, IUDs have gotten a bad rap largely due to the case of the Dalkon Shield which was pulled off the market in the 1970s after women who used it developed pelvic infections.

However, she added, there are now 20 years' worth of data backing the safety and effectiveness of today's copper and levonorgestrel IUDs.

"Families and young people are concerned about safety and these are medical devices and medications, so they have side effects," Ott told Washington Post. "But I always remind families when I'm counseling them that all methods of contraceptives are safer than pregnancy."

Under the Affordable Care Act, insurance plans now must cover FDA-approved contraceptives which include IUDs, with no out-of-pocket costs. Without insurance, IUDs may cost between $500 and $1,000 up front, according to Planned Parenthood.

ABC News advised that adolescents, who are sexually active, talk to their doctors about the best birth control option.

Sources:

Dr. Bhuyan, Natasha. "IUDs, Implants Could Cut Teen Pregnancy Rates 80 Percent." ABC News. ABC News Network, 3 Oct. 2014. Web. 5 Oct. 2014.
http://abcnews.go.com/blogs/health/2014/10/03/iuds-implants-could-cut-teen-pregnancy-rates-80-percent

Harding, Anne. "Best Birth Control for Teens: Implants, IUDs." LiveScience. TechMedia Network, 29 Sept. 2014. Web. 5 Oct. 2014.
http://www.livescience.com/48050-best-birth-control-teens-implants-iuds.html

Izadi, Elahe. "Pediatrics group recommends IUDs, implants as best birth control for teen girls." Washington Post. The Washington Post, n.d. Web. 5 Oct. 2014.
http://www.washingtonpost.com/news/to-your-health/wp/2014/09/29/pediatrics-group-recommends-iuds-implants-as-best-birth-control-for-teen-girls

Reviewed October 16, 2014
by Michele Blacksberg RN
Edited by Jody Smith