Eliminating Barriers to Teen Contraception

Published - Written by John Staples

Unplanned pregnancy can be a lucrative topic for Hollywood, with movies like Precious, Boyhood, Juno and Knocked Up collectively making hundreds of millions of dollars. Yet what’s profitable for producers comes at great socioeconomic cost to teen mothers and their children. Watching a movie about this public health problem isn’t likely to help. Is there another option?

In this week’s NEJM, Dr. Gina M. Secura (Washington University, St. Louis) and colleagues describe the results of the Contraceptive CHOICE Project, a program that promotes long-acting reversible contraceptive methods in order to reduce unintended pregnancy in the St. Louis region. After obtaining parental consent, teen participants were provided with screening for sexually transmitted infections, contraceptive counseling, and their choice of reversible contraception – all at no cost.

Participants were then followed by biannual telephone interviews for 2 to 3 years. The investigators found an annual average of 34 pregnancies, 19 live births, and 10 induced abortions for every 1,000 teens in the CHOICE cohort. In comparison, sexually-experienced U.S. teens have 159 pregnancies, 94 births, and 42 abortions per 1,000 teens. The authors conclude that programs that remove barriers to contraception may be of substantial public health importance in the United States.

“Teen pregnancy rates are much higher in the United States than they are in many other developed countries,” says cardiologist and NEJM Executive Editor Dr. Gregory Curfman. “The contraceptive mandate with the Affordable Care Act requires coverage of contraception without a copayment, and this study suggests that such coverage may be an effective way to prevent teen pregnancy.”

Lower rates of teen pregnancy? That sounds like a box office preview of something we’d all like to see.

These findings are also summarized in a short animation. Watch it now!

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