Pediatricians offer new birth control recommendations for teen girls

Last Updated Sep 29, 2014 9:05 PM EDT

Teen girls who are sexually active should use IUDs or hormonal implants -- long-acting birth control methods that are effective, safe and easy to use, the nation's most influential pediatricians' group recommends.

In an updated policy issued Monday, the American Academy of Pediatrics says condoms also should be used every time teens have sex, to provide protection against sexually transmitted diseases that other forms of birth control don't provide, and to boost chances of preventing pregnancy.

Condoms alone are the most common birth control choice among teens, but with typical use they're among the least effective methods at preventing pregnancy. Both long-acting methods are nearly 100 percent effective, with lower failure rates than birth control pills, patches and injections, the academy says.

"They're focusing on this group because data has shown most kids in high school -- more than half -- have sex, and 80 percent of teen pregnancies are unplanned," said Dr. Holly Phillips, medical contributor on "CBS This Morning." "What they're really doing is acknowledging that pediatricians are often the first person to talk about sex and contraception with teens. And so they want pediatricians to offer contraceptive options in order of their effectiveness."

IUDs and hormonal implants cost more, usually hundreds of dollars, because inserting them involves a medical procedure typically done in doctors' offices. But they're less expensive in the long run than over-the-counter condoms or prescription birth control pills, said Dr. Mary Ott, lead author of the policy statement and a an adolescent medicine specialist and associate pediatrics professor at Indiana University.

Teens have to remember to use pills and condoms consistently. By contrast, IUDs typically work for three to 10 years after insertion, while implants typically last three years.

The new guidance was published Monday in Pediatrics. It echoes 2012 recommendations from the American College of Obstetricians and Gynecologists.

The policy emphasizes that abstinence is 100 percent effective at preventing pregnancy and sexually transmitted diseases and says pediatricians should encourage teens to delay sexual activity "until they are ready." But since many teens don't heed that advice, the policy also says pediatricians need to provide birth control guidance.

IUDs, or intrauterine devices, are small, T-shaped devices containing hormones or copper that are inserted into the womb to prevent pregnancy. Hormone-containing birth control implants are matchstick-size plastic rods placed under the skin of the upper arm.

"All methods of hormonal birth control are safer than pregnancy," Ott said. Other hormonal birth control options include pills, patches and injections.

For the first time, the new policy addresses obese teens because pediatricians are seeing increasing numbers of patients whose excess weight may affect birth control effectiveness, Ott said. For example, hormonal patches may be less effective in girls weighing more than 198 pounds, the policy says. Also, obese girls are more likely to gain weight with hormonal injections than with birth control pills.

The academy's new advice updates a 2007 birth control policy that didn't recommend specific methods other than condom use.