Report: Women embrace more effective birth control

The most effective methods of reversible birth control are rapidly gaining popularity among U.S. girls and women, a new report shows.

More than 7% of girls and women ages 15 to 44 used intrauterine devices (IUDs) and hormone implants in 2011-2013, up from 1.5% in 2002, says the report from the federal Centers for Disease Control and Prevention.

While birth control pills remain the most popular option, used by 16%, the growth of so-called long-acting reversible contraception (LARC), "is a pretty significant change in the contraceptive world," says study co-author Amy Branum.

Because the methods are much more effective than birth control pills, "it's going to be fascinating to see what impact this will have on overall fertility rates and teen pregnancy," Branum says. She is a researcher at the CDC's National Center for Health Statistics.

IUDs, once widely shunned due to safety concerns, started making a comeback after new versions were introduced in the early 1990s. They caught on more rapidly after 2000, the report shows. Hormonal arm implants were introduced in the 1990s and also have caught on as new versions have been introduced, Branum says.

IUDs are T-shaped devices placed inside the uterus for three to 10 years. They prevent pregnancy by releasing hormones or copper. Matchstick-size arm implants release hormones for up to three years. All the devices have failure rates below 1%, CDC says. The pill's failure rate is about 9% for typical users – partly because women sometimes forget to take them.

The new report details who is using the long-acting methods and where growth is fastest. In 2011-2013, use was highest among women ages 24 to 34 and those who already had children. But growth was fastest among younger girls and women and those with no children.

"Long-acting methods are the future, and I think we are going to see continued growth, especially among young people," says Jeffrey Peipert, a professor of obstetrics and gynecology at Washington University School of Medicine, St. Louis.

Peipert, who was not involved in the government report, says his research suggests wider use of long-acting methods will cut already-falling teen pregnancy and abortion rates.

The main reason they work so well is that "you put them in and you forget about them," he says.

In 2014, the American Academy of Pediatrics said doctors should counsel sexually active teen girls that IUDs and implants are the most effective methods. The American College of Obstetricians and Gynecologists also lists them as first-line choices for teens and adults.

The biggest barrier to wider use, Peipert says, is that many doctors still don't mention them to patients. Cost also can be an issue, for uninsured women and others whose insurers have balked at covering the devices. They can cost up to $1,000.

The Affordable Care Act calls for insurers to cover all birth control methods, but some employers have objected for religious reasons.

Another concern: the devices do not protect against sexually transmitted diseases, so condoms are still needed. Also, the insertion of an IUD can be briefly painful, and arm implants can cause unpredictable menstrual bleeding.

LARC use in 2011-2013:

Ages 15-24: 5%

Ages 25-34: 11.1%

Ages 35-44: 5.3%

LARC use in 2002:

Ages 15-24: 0.6%

Ages 25-34: 2.9%

Ages 35-44: 1.1%

Source: National Center for Health Statistics