Over the course of five years, researchers at Washington University in St. Louis provided free contraception (access and comprehensive education on all options) to thousands of local women as part of the CHOICE Contraceptive Project. Among 1,404 teenage women who had their pick of birth-control and thorough counseling on the plusses and minuses of each method, 74 percent chose IUDs or implants.

Teen Birth Rates (Per 1,000 Women)

The St. Louis group showed that when women have access to all types of reversible birth-control at no cost, rates of teenage pregnancy and abortion plummet. The rate of unplanned pregnancy among the study population was just 3.4 percent, compared to a national average of 15.9 percent.

And less than 1 percent of the women had abortions, compared to a national average of 4.2 percent. That's consistent with known long-term trends.

Rates Among Women Ages 15 to 17 (Per 1,000 Women)

(CDC/NCHS, Guttmacher Institute)

The takeaway, according to Dr. Jeffrey Peipert, the principal investigator and a professor of obstetrics and gynecology, is that with a little more investment in getting people access to information about LARC, everyone wins. The key is educating not just patients, but doctors, many of whom are not comfortable implanting these devices and/or were not trained to recommend IUDs to young women. One long-standing reservation about IUDs in young women was a high risk of expulsion from the uterus, which was evident in the CHOICE project; but the IUDs were falling out at lower rates than people who opted to take the pill were forgetting to take it.

Peipert believes that because many pediatricians and gynecologists are only beginning to suggest long-acting reversible contraception to young patients, the tide is set to turn. It was not until 2012 that the American College of Obstetricians and Gynecologists recommended that doctors should encourage LARC among teenage patients, and it was not until this Monday that the American Academy of Pediatrics (AAP) announced new guidelines in the journal Pediatrics: Because of their effectiveness, safety, and ease of use, LARC methods should now be considered the contraceptives of choice for adolescents.

Birth-control pills fail 9 percent of the time (only 0.3 percent of the time when used “perfectly,” according to the AAP, which is uncommon), and male condoms fail 18 percent of the time when they are used alone (2 percent of the time when used consistently (“perfectly”)). IUDs have no such discrepancy in effectiveness; it requires a feat of creativity to misuse an IUD. So levonorgestrel IUDs fail 0.2 percent of the time, end of story. Contraceptive implants, which are placed under the skin of a woman’s upper arm and last several years, are even more reliable, with a failure rate of just 0.05.