Teen pregnancy is down in Pennsylvania and across the country. But pregnancy rates for black and Latina teens in the state are four and six times higher than rates for their white counterparts.
Though the exact causes of the overall decline in teen pregnancy have not been identified, the Centers for Disease Control and Prevention point to increased birth control use among teens as a major factor.
Research shows that long-acting forms of birth control, such as intrauterine devices and arm implants, are by far the most effective methods of birth control — up to 20 times more effective than the pill.
But very few Pennsylvania teenagers — only about 3 percent — use these methods.
A new program run by Public Citizens for Children and Youth aims to give teenage girls in Philadelphia a sense of their birth control options. The program will offer workshops to girls 13 and older in high schools and after-school settings. The idea is to make sure teens know that long-acting birth control methods are safe, effective options, even if their parents or doctors might not bring them up.
“Too often, information is excluded about IUDs and implants,” said Colleen McCauley, head of health policy at PCCY. “That’s particularly true for girls and women of color, who have disproportionately experienced differential treatment care and counseling when it comes to family planning.”
Experts say many doctors feel uncomfortable offering long-acting birth control methods to teens. That includes those who specialize in adolescent medicine and are uncomfortable talking about long-acting reversible contraceptives — also known as LARC methods — with young people, and those who specialize in LARCs but aren’t as comfortable in adolescent care.
Medicaid did not reimburse Pennsylvania providers for these methods until 2016.
For a long time, McCauley said, LARCs were thought of as a method for older women who didn’t want to have more children but could still become pregnant. They weren’t considered options for teens.
“But, over time, the science over LARCs has improved around these methods, and they are safe for girls and women to use of all ages,” she said.
Gaining awareness and options
Brianna Crooks, a 17-year-old high school senior, has been on the pill for the last year or so as a way to regulate her periods.
She said implants and IUDs were presented to her as potential options only once she told her doctor she was having trouble remembering to take the pill regularly. She was skeptical.
“When I heard about the IUD, I have to admit was a little bit wary because I didn’t know how it worked,” said Crooks. “You know how you’re always afraid of the unknown?”
Her fear caused Crooks to stick with the pill, though she’s open to the idea of an implant or IUD the more she learns. She said most of her friends are also on the pill, but she thinks that’s likely just a product of education.
“More people are geared towards the pill, I feel like, because that’s what’s really around us and there’s not really awareness around IUD and implants,” said Crooks. “But I feel like if we gained more lessons and awareness … I feel like more people would utilize the option more.”
Colorado launched a public education campaign similar to PCCY’s in 2008. It now has the highest rate of long-acting birth control use in the nation, and in the years following, teen birth rates declined by half.
Nationally, teens who become pregnant are much more likely to drop out of high school — only 50 percent of teenage moms earn high school diplomas by the time they are 22.
Critics warn that relying too heavily on LARCs as a tool to cure social ills or end poverty could replicate the coercive practices that caused some communities of color to be wary of LARCs in the first place.
McCauley said the new program is designed to ensure that teens understand all their options, so they can make informed decisions that make the most sense for them.