The American Academy of Pediatrics Committee on Adolescence has issued a new policy statement that recommends the safest and most effective contraceptive options for teenagers.
The policy statement, an update of the AAP’s 2007 statement, advises pediatricians counseling adolescents to recommend single-rod progestin implants and intrauterine devices (IUDs) as the first and second-best birth control options, followed, in order, by progestin-only injections every 13 to 15 weeks; combined oral contraceptive pills (COCs); and condoms, the most frequently used birth control method. Combined oral contraceptive pills and condoms aren’t the best options because teenagers don’t always use them consistently.
Long-acting reversible contraception-implants and IUDs-has the advantage of equal or almost equal efficacy (failure rate of less than 1%) with both typical use and perfect use; injection, COCs, and condoms are less effective as typically used. Long-acting reversible contraception also has the highest percentages of continued use by women at 1 year after initiation. Both implants, which can remain in place for 3 years, and IUDs are considered safe for adolescent girls.
Abstinence, the only completely sure way to prevent pregnancy and sexually transmitted infections, remains an important part of contraceptive counseling, and pediatricians should encourage adolescents to postpone sex until they’re ready, the statement notes. Data indicate that adherence is low, however.
The policy statement-which also includes advice on contraception counseling for obese teenagers and adolescents with disabilities and complex medical conditions (chronic disease, HIV, solid organ transplants)-is supported by an accompanying technical report.
To get weekly clinical advice for today's pediatrician, subscribe to the Contemporary Pediatrics PediaMedia.