Offering Teens a Real Choice: Long-Acting Reversible Contraception
Safe, effective contraception can be a modern miracle for people who want a healthy sex life, but don’t want to conceive a child.
But let’s be honest: while worth every hassle, many of the most widely available methods (condoms, pills, injections, etc.) can be challenging to use correctly. There are daily tasks to remember and additional visits to a clinic or pharmacy to schedule.
These challenges can be particularly acute for young people. In most parts of the world, adolescents face social and legal restrictions on their access to confidential sexual health services. They also may not be in complete control of when they can leave the house or create free time, and may face imbalanced power dynamics in their sexual relationships, making tasks like condom negotiation especially difficult.
Young people are also highly likely to be in the position of wanting to prevent or delay parenthood by several years.
Meeting adolescents' unmet need for long-acting reversible contraceptives would significantly decrease unplanned pregnancies, the related threats of maternal and child morbidity and mortality, and unsafe abortion.
The sad result: high rates of unintended pregnancies, unsafe abortions, and unmet need for contraception.
And yet, until now, the use of long-acting reversible methods of contraception (LARC), such as IUDs and implants, which so many older women rely on, has been discouraged among adolescents if not outright prohibited.
Thankfully, there have been several recent U S studies that demonstrate not only the safety of young people using LARC, but also the appeal of such methods to adolescents. A 2014 study involving 1,404 teenage women found that when given a choice, 72% choose a long-acting reversible contraceptive.
Similar data is hard to come by when considering adolescent populations in the developing world, but it stands to reason that the safety of these methods in adolescents would be similar. Furthermore, appeal and satisfaction in adolescents in developing countries is now beginning to be demonstrated in a diversity of such countries.
While global consensus is building on the safety and value of ensuring access to LARC for adolescents, there is still much work to be done to shift long-standing patterns which interfere with that access. Decades of discouragement have resulted in many medical providers holding bias against the recommendation, many if not most adolescents do not realize these methods are options for them, policies and social stigma continue to hinder progress.
As one step forward, key stakeholders came together last week in Washington, D.C. to look at the tough questions around voluntary long-acting contraceptives for young women. You can follow our conversation online at #LARCs4youth. While it will take time and an unrelenting effort, the meetings did reinforce two truths:
- There is significant unmet need in adolescents worldwide, which from a rights-based approach can and should be filled with a broad mix of contraceptive methods, including full-access to long-acting reversible contraceptive..
- Meeting adolescents’ unmet need for long-acting reversible contraceptives would significantly decrease unplanned pregnancies, the related threats of maternal and child morbidity and mortality, and unsafe abortion.
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