Prevention of Unintended Adolescent Pregnancies Through Greater Access to Long Acting Reversible Contraceptives

Adolescent pregnancies have negative implications not only for the teen parent but also for society making unintended teen pregnancies an important public health issue. In the United States (US) adolescent females aged 15-19 years old had a birth rate of 24.2 births per 1000 women in the year 2014 (Romero, et al, 2015). Subsequently, women who enter into motherhood as teens have significantly lower high school graduation rates and higher rates of poverty. Only 50% of adolescent mothers receive a high school diploma compared to over 90% of adolescent girls who are not mothers (Centers for Disease Control and Prevention [CDC], 2015). A sordid history has caused long-acting reversible contraceptives (LARCs) to traditionally not be marketed to adolescents. Although almost half of US adolescents aged 15-19 are sexually active, less than 5% of adolescent’s report using a LARC (American College of Obstetricians and Gynecologists [ACOG], 2012). As of 2014, the ACOG and the American Academy of Pediatrics (AAP) recommend LARCs for all women of childbearing age as the most effective form of birth control to prevent unintended pregnancies. Despite these recommendations, adolescents continue to face barriers when attempting to obtain a LARC as a method of contraception. Lack of youth-friendly services, cost, provider perception of LARC use in adolescents, and gaps in LARC insertion and removal training, prevent adolescents from choosing to take advantage of a LARC to prevent unintended pregnancies (ACOG, 2012). This paper undertakes a review of policy regarding adolescents access, education and utilization of LARCs and presents recommendations for policy changes and other approaches based on established research methods to eliminate barriers facing adolescents in their reproductive choices.Master of Public Healt