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Birds, Bees, and IUDs

Birth control is a tricky subject, especially when it comes to teens. Many states, including Utah, do not allow any discussion of birth control other than of abstinence in classrooms. Now though, the American Academy of Pediatrics (AAP) is encouraging Pediatricians to have those conversations with their teenage patients, and they have a very specific recommendation when it comes to the kind of birth control that is best.

In guidelines published recently the AAP says that intrauterine devices (IUDs) and progestin implants should be considered the "first line" of defense in preventing teen pregnancy. We sat down with Joni Hemond, MD, a pediatrician and medical director for University of Utah Health's Teen Mother and Child Program to get more information about the AAP's announcement.


Why are IUDs and implants a preferred method of birth control?

They provide long-acting reversible birth control without the user having to remember to take a pill every day or come into the office on a regular basis.


What about birth control pills?

While this is a safe and effective form of contraception, it requires the user to take a pill (preferably at the same time) every single day. It is very effective with "perfect" use, but it is very difficult for teenagers who tend to have busy lives, to remember to take it every single day. Missing pills makes it much less effective.


Are these methods still preferred for girls who may be using birth control to regulate periods, not prevent pregnancy?

Yes, OCPs are still recommended to regulate periods. IUDs and implants may be effective at regulating periods, but can be associated with a higher risk for unexpected vaginal bleeding.


Should teens get birth control from their pediatrician, or should they be referred to a gynecologist?

This is doctor dependent. Most pediatricians feel comfortable counseling about different birth control methods and can prescribe contraceptive pills, but most pediatric offices are not equipped to place implants or IUDs. In areas where an adolescent medicine specialist is available, they are able to place implants and IUDs.


How should parents feel about this recommendation?

IUDs and implants are safe, very effective long-acting, reversible forms of contraception. It is important to remember, as with all hormonal contraception, that they do not protect against sexually transmitted infections (STIs).