Roughly one of every two pregnancies in Michigan is unplanned. About half of the time, incorrect or inconsistent use of birth control is a factor.
That’s why both the American College of Obstetricians and Gynecologists and the American Academy of Pediatrics recently recommended long-lasting contraceptives as the preferred method of birth control—even for teens.
“Today’s long-lasting contraceptives are safe for all ages, and they’re 20 times more reliable than birth control pills, the patch or vaginal rings,” said Elizabeth Leary, MD, a gynecologist with the Spectrum Health Medical Group. “Plus, they’re reversible. So when you are ready to welcome a new addition to your family, you have that option.”
Long-acting contraceptives include birth control implants and intrauterine devices, also called IUDs.
A birth control implant is inserted into your arm. This is a flexible rod, about the size of a matchstick, which contains progestin to stop ovulation, thicken the cervical mucus and change the lining of your uterus. It protects against pregnancy for up to three years.
An IUD is inserted into your uterus. There are two types of IUDs, and they’re both shaped like the letter T. The hormonal IUD uses progestin, a synthetic form of progesterone, to prevent pregnancy by stopping ovulation, thickening the cervical mucus and changing the lining of your uterus. It protects against pregnancy for up to three to five years. The copper IUD prevents fertilization of the egg by the sperm without using hormones. It is approved for use for up to 10 years.
When choosing long-lasting contraceptives, Dr. Leary recommends looking at your long-term goals and potential side effects.
Both the birth control implant and the hormonal IUD use progestin, which can cause spotting and irregular bleeding for the first few months. With the hormonal IUD, about 30 percent of women have no periods after the first year, and 70 percent don’t have periods after three years. This makes it popular with young people and athletes. The Food and Drug Administration has also endorsed hormone-based IUDs to alleviate heavy menstrual bleeding.
Copper IUDs are hormone-free. This is a plus for women who prefer not to use hormones or who can’t for medical reasons that could include a history of breast cancer or blood clots.
If your mother (or grandmother) is worried about IUDs, it’s probably because she remembers the old Dalcon Shield, which was removed from the market 40 years ago. These old-school IUDs sometimes allowed bacteria to infect the uterus and cause pelvic inflammatory disease.
“IUDs got a bad rap in the ’70s,” Dr. Leary said. “But, due to earlier concerns, modern IUDs are among the most studied medical devices around.”
Thanks to health reform, many women and teens can get any type of birth control for free from in-network providers. Their insurance company pays the actual cost, including the $1,000 to $1,500 fee for long-lasting, reversible contraceptives. (Check with your insurance company or your employer for details.)