THURSDAY, Oct. 4, 2012 — Long-acting methods of birth control — such as intrauterine devices (IUDs) and implants — can dramatically reduce the number of unwanted pregnancies and abortions if they are provided at no cost to patients, says a new study, which appears online in Obstetrics & Gynecology. Researchers report that open access to long-term contraceptive options could cut the numbers of unintended pregnancies at rates between 62 and 78 percent.

"A lot of women don't know about these methods [IUDs and implants]," says Gina Secura, the project director of the Contraceptive Choice Project at Washington University School of Medicine in St. Louis, which conducted the study on 9,256 women between the ages 14 to 45. "For the pill, patch, and ring, we saw much more unintended pregnancy in young women."

In the five-year long study, participants received counseling on available birth control options, which included short-acting hormonal methods like the pill, patch, and ring in addition to long-acting devices. Around 75 percent of the women in the study chose IUDs or implants. Secura says the majority of women under 20 selected implants, while those in the older age cohort favored IUDs.

Teens enrolled in this free birth control program had an annual birth rate of 6.3 per 1,000 participants, compared with the national rate of 34.3 per 1,000 for girls in the same age demographic. The authors say the abortion rates among study participants were also significantly lower than typical rates in St. Louis, where the study was conducted.

IUDs and implants are clinically reported to have the lowest failure rates among reversible contraceptives currently on the market. According to a 2011 study published in the journal Contraception, both devices are more than 99 percent effective, compared with 91 percent for birth control pills and 82 percent for condoms.

Each year in the United States, around 50 percent of pregnancies are unplanned, half a result of skipping or misusing contraceptives. In the duration of the study, the authors report annual abortion rates among study participants ranged from 4.4 to 7.5 per 1,000 women per year. They say the national rate is currently 19.6 abortions per 1,000 women in 2008, which are the most recent figures available.

But while IUDs and implants are said to be nearly foolproof birth control methods, they are also the most expensive among reversible options. In the United States, IUDs and implants can cost as much as $800, which includes the price for insertion. Though these devices are a good investment over the duration of time for which they are effective — an average of three to five years — they also typically must be paid for in full at the time of insertion, a financial burden for many patients.

"The longer you use it the more cost-effective it is," says Secura. "It's women who are using other [hormonal] methods who are stopping sooner."

But Secura also says healthcare providers are not typically educating and encouraging their patients to consider IUDs and implants as a viable option.

"There's some retraining that needs to happen," she says."We'll see a shift as women demand them and providers become more familiar with evidence-based practices."