Preventing Teen Pregnancy, One Contraception Talk at a Time

49% of pregnancies in the United States are unintended1. That means that about one out of every two women who gets pregnant had no plan of getting pregnant when she did. This statistic was staggering when I first heard it. Even now, eight months later, it’s still hard to fully wrap my head around. This percentage can also increase depending on what age groups you’re looking at. For instance, in women under 19, four out of five pregnancies (80%!!) were unintended1. 
Because May is Teen Pregnancy Prevention Month, it seems like a great time to talk about contraception. Before we get to that though, let’s learn a little bit more about teen pregnancy in the U.S. As of 2014, the teen birth rate was 24 births per 1000 girls aged 15-19- costing about $9.4 billion annually… 9.4 billion dollars…a year…2The national teen birth rate has declined significantly by 41% from 2006 to 20143. However, even after this decline, there were still 249,078 teen births in 20142.
As an AmeriCorps Member who has spent a large portion of my term focusing on family planning and contraception options counseling, these statistics scream out for greater access to birth control. However, I’m very aware that not all birth control methods are right for everyone, which is why it’s so important that women are talked through the effectiveness, benefits, and risks of each method, and empowered to make the best decision for themselves. I also realize that even though 49% of all pregnancies were unintended, there is still a large number of women who do want to become pregnant. That’s why I start every contraception conversation with a simple question: “would you like to become pregnant in the next year?” Depending on what a women answers, I can gauge whether we should be talking about preconception health or contraception options. Since there are so many different contraception options, when choosing the best method, it is helpful to look at them side by side. Bedsider has a great interactive site which goes through all the pros, cons, etc. of each method  (https://bedsider.org/methods).
Here are some other things to keep in mind when choosing, or helping someone else choose the best contraception method:
LARC = great: Long Acting Reversible Contraception are some of the most effective and low maintenance birth control methods available. LARC consists of Intrauterine Devices (IUDs) and the Implant (Nexplanon), and can be really great options for women who are not looking to become pregnant in the next year (or five).
Perfect use vs. typical use: When comparing effectiveness of birth control methods, there are two percentages that can be compared. One is the effectiveness with perfect use, which is how well the method worked in the clinical trial. The other is typical use, which is how well the method works in real, busy, heat of the moment life. These numbers can be very different. For instance, condoms’ effectiveness with perfect use is 98%, but with typical use, the effectiveness drops to 82%4. Just something to be aware of.
Every woman is different: which means that every woman also has a different reason for choosing a contraception method. It isn’t my (or any health care provider’s) place to tell her which would be her best option. It is more useful to explain all of the options, and assist her in choosing a method that she thinks will work best in her life. 
ObamaCare: Under ObamaCare, all insurance plans must cover at least one FDA approved contraception method at no out-of-pocket expense to the individual5. Some plans cover more than one method. The best way to find out what’s covered under your insurance plan is to call your individual plan and ask whether the specific method you’re interested in is covered.
You can change methods whenever you want: Just because you’re using the pill right now, doesn’t mean that you have to use the pill forever. If you’ve decided you’re ready for a change, do some research and talk to your doctor about switching.
Although there are many social determinants of health, such as access to education or health care services, which contribute to high rates of teen pregnancy (and unintended pregnancy) in the U.S., contraception options counseling is one technique for prevention. It will most likely not be the only solution to the problem, but it is a pretty darn good start.

References
1. http://www.cdc.gov/reproductivehealth/unintendedpregnancy/
2. https://thenationalcampaign.org/data/landing
3. Romero L, Pazol K, Warner L, et al. Reduced Disparities in Birth Rates Among Teens Aged 15–19 Years — United States, 2006–2007 and 2013–2014. MMWR Morb Mortal Wkly Rep 2016;65:409–414. DOI: http://dx.doi.org/10.15585/mmwr.mm6516a1  
4. https://bedsider.org/methods/condom#details_tab
5. http://obamacarefacts.com/obamacare-birth-control/