Free Long-Acting Contraception Lowered Unwanted Pregnancy and Abortion Rates

Dr. Jeff Peipert MD, PhD Institute for Public Health Robert J. Terry Professor, Department of Obstetrics & Gynecology, School of Medicine Washington University in St. LouisMedicalResearch.com Interview with:
Dr. Jeff Peipert MD, PhD
Institute for Public Health
Robert J. Terry Professor, Department of Obstetrics & Gynecology, School of Medicine
Washington University in St. Louis

Medical Research: What are the main findings of this study?

Dr. Peipert: In the Contraceptive CHOICE Project, over 70% of teenage girls and women who were provided no-cost contraception and were educated about the effectiveness and benefits of long-acting reversible contraceptive (LARC) methods selected the intrauterine device (IUD) or contraceptive implant.  This group of over 1400 young women aged 15-19 years had rates of pregnancy, birth, and abortion that were far below national rates for sexually experienced teens.

Medical Research: What was MOST surprising about the results?

Dr. Peipert: Most surprising was the number (and percentage) of teens selecting these highly effective long-acting reversible contraceptive methods: 72%.  In addition, the magnitude of the difference of pregnancy, birth, and abortion rates compared to national statistics was remarkable.

Medical Research: What should clinicians and patients take away from your report? 

Dr. Peipert: IUDs and implants are first-line contraceptive methods for women of all ages, including teens.  Satisfaction and continuation rates with these methods far exceed the commonly used birth control pills.  By providing long-acting reversible contraceptive methods to women and teens who desire them, we can reduce unintended and teen pregnancies in the U.S.

Medical Research: What recommendations do you have for future research as a result of this study?

Dr. Peipert: We are currently studying how to best disseminate these findings to other clinics and other areas of the U.S. and beyond.  How can we change the practice of primary care clinicians to be more “LARC-friendly” and offer these methods to all women?  What are best practices for counseling and informing women about the contraceptive and health benefits of long-acting reversible contraceptive?  Given the constraints on insurance coverage for contraception, how do we make long-acting reversible contraceptive methods (and all contraceptive methods) available to all women in the U.S. at no cost?  Family planning (and especially long-acting reversible contraceptive methods) saves health care dollars.  We should further quantify this savings and present this information to policy makers and the lawmakers so that women have access to all methods at no cost.

Citation:

Provision of No-Cost, Long-Acting Contraception and Teenage Pregnancy

Gina M. Secura, Ph.D., M.P.H., Tessa Madden, M.D., M.P.H., Colleen McNicholas, D.O., Jennifer Mullersman, B.S.N., Christina M. Buckel, M.S.W., Qiuhong Zhao, M.S., and Jeffrey F. Peipert, M.D., Ph.D.

N Engl J Med 2014; 371:1316-1323
October 2, 2014DOI: 10.1056/NEJMoa1400506