IUDs for teens? Endangering, not empowering, docs say

Washington D.C., Oct 12, 2014 / 05:35 am

Medical professionals blasted the American Academy of Pediatrics' recent recommendation that long term contraceptives are the best way for teen girls to avoid pregnancy, saying that it sends an unhealthy message.
 
"It's not an empowering message to the young woman. It's a message that's indicating to her that, 'We know you cannot protect yourself by having good lifestyle choices,'" Dr. Marie Hilliard of the National Catholic Bioethics Center told CNA Oct. 6.

Last week, the American Academy of Pediatricians released an updated policy statement on contraception for adolescent girls, saying that long term birth control such as intrauterine devices (IUDs) or progestin implants are the best methods for reducing teen pregnancy in the U.S.

"They've offered young women two lies, and perhaps two life-altering choices, without the life-affirming choice that human sexuality is a beautiful thing and it should be exercised within a committed, lifelong relationship," Dr. Hilliard said.

She pointed to the physical, emotional and psychological risks that come from sexual activity during the teenage years.

"If you look at the statistics on STDs from 2001 over the next decade, Syphilis has doubled and Chlamydia has gone from 271 per 100,000 persons to 453 per 100,000 persons," she observed.

In 2012, the American College of Obstetricians and Gynecologists updated its guidelines for teenagers to say that IUDs and hormonal implants should be "first-line contraceptive options" that are discussed at each doctor's visit.

Now, the American Academy of Pediatrics has followed suit.

The American College of Pediatricians – a separate group – responded in a statement saying that recommending long-term contraceptives to teens "blatantly ignoring the harms of promiscuous sexual activity to the individuals involved."

The new policy recommendation "erroneously conveys the impression that sexual activity is an expected recreational activity among most teens and that contraception is the answer," the college said, also noting that the statement seeks to downplay the role of parental oversight and involvement.  
 
"Our primary message to adolescent patients must not be contraception, but rather the tremendous physical, psychological and even future marital benefits in delaying all sexual activity until after marriage. Anything less is a compromise," said Dr. Den Trumbull, president of the American College of Pediatricians.

Dr. Hilliard said the recommendation seems to disregard literature associated with these two types of contraception.

Per manufacturer recommendations, IUDs are meant to be used in a mutually monogamous relationship. Progestin injections, such as the popular Depo-Provera, should only be used for two years – not long term – and carry a risk of lost bone mineral density, blood clots, and ectopic pregnancy.

"We're talking about teen girls here; teen girls who are receiving a message implicitly by such advice that it is not unhealthy for you to be sexually active," Hilliard said.

"These are developing young women," she emphasized. "They're not at the point of marriage. They're not (necessarily) going to be in monogamous relationships."