• Wed, Aug 20 - 3:22 pm ET

Colorado Took A Simple, Obvious Step And Had Biggest Drop In Teen Pregnancy Rate In Years

teen pregnancyColorado has seen the highest drop in teen birth rates in the entire country, and officials are putting the credit for that on a new family planning initiative that offers low-income women long-acting, reversible birth control methods (e.g. IUDs and implants) for little to no cost. And guess what? It actually works. It works really, really well.

This new initiative to offer long-lasting and reversible birth control instead of the pill or condoms is said to be responsible for three-quarters of the decline in the state’s teen birth rates, down 39% compared in the national drop of 29%.

After a teen gives birth, she is offered an IUD or implant before she leaves the hospital.

It’s a plan that should have everyone slapping their foreheads and saying, “Why didn’t we think of that?” After all, what would seem to be the best way to keep a teenager from getting pregnant — asking them to use short-term birth control via condoms, taking the pill everyday, or ineffective pleas for abstinence, or would it be better to give them an IUD that they don’t have to think about and is 99% effective for the next few years? They don’t have to convince their partners to wear a condom and they don’t have to make a choice every day about how they feel about getting pregnant (we are, of course, looking at pregnancy and not STDs, here). To underline the point, Colorado also had a 50% drop in teens with repeat pregnancies during the policy shift.

As Greta Klingler, the family planning supervisor for the Colorado Department of Public Health and Environment put it in the Washington Post:

If you have a drug that is 20 times more effective than other drugs, you will always start with that as your first option. What we did (in the Colorado Family Planning Initiative) is kind of flip the mindset, so rather than introducing all contraception as being on the same playing field, we said, ‘Let’s start with what is most effective.’

In fact, Colorado officials found that among new moms who chose short-term birth control upon leaving the hospital, 20% were pregnant again a year later as opposed to 2.6% of the moms who got implants. Another year later, 8% of the moms with implants were pregnant, while 46% of those who did not have long-lasting birth control were.

That’s big.

I am not sure why other states haven’t already done this — I assume it has something to do with money or lobbyists because I am a cynic. But compare the cost of providing long-lasting birth control to teens versus the cost to taxpayers of caring for those unintended pregnancies: the Center for Disease Control says the lowered birth rate saved $12 billion dollars in health care and child care in 2010 alone. So if money is your issue, then you can be reassured there.

Let’s not expect teenagers to be responsible all of the time. Let’s lessen their burden and help them dream of bigger and better futures. Let’s show them that we really do give a damn by putting our money where our mouth is and respecting them enough to give them a fighting chance.

(photo: Monkey Business Images / Shutterstock)

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  • Katherine Handcock

    What a terrific initiative! People really do underestimate how much of a problem the cost of birth control can be.

  • NotTakenNotAvailable

    I have a few guesses as to what other states’ problems are–the far right crowing about how premarital sex will destroy the fabric of our society. But here, we can just pass the wackos a fat blunt to shut ‘em up.

    I think it does help that this is a privately funded initiative, from what I’d heard elsewhere.

    • Kheldarson

      I think that “privately funded” bit is the biggest reason this is even in place. I’d be interested in seeing if any states can succeed in pushing such an initiative on their own budget.

    • NotTakenNotAvailable

      Probably not until we can start passing fat blunts across state lines. :(

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  • Lilly

    My inner math nerd is wondering about the 2.6% and 8% who got pregnant after getting the implants — is that a failure rate or are these women getting the implants removed? Because those are higher then the stated failure rates for IUDs and hormone implants and kind of freak me out a bit.

    • Andrea

      I scratched my head at that too. The implant is supposed to be 99% effective and you don’t have to do anything to make it effective, right? It just is?
      So is it failing or are they removing it? Removing it requires you to go to the doctor, so I’m guessing it was a conscious and willful decision to get pregnant again?
      Cuz I don’t buy that fail rate from an IUD.

    • http://www.pileofbabies.com/ Meredith Bland

      Answered above! Sorry for the confusion!

    • koolchicken

      I don’t believe it either. I picked an IUD because it’s the next best thing to sterilization. In fact it supposedly works better than a tubal cause those sometimes don’t hold (shudder).

      I’d be willing to bet the failure rate is higher since they’re inserting them right after giving birth when the expulsion rate is higher. You’re supposed to wait for I think six weeks for the best results. Also, teens probably aren’t being as careful with them. If the cord somehow became snagged on a tampon or something they might be less inclined to care. I asked my husband and he said IUD’s are in there pretty good, and don’t slip easily, but anything can happen. And they do sometimes get expelled from some people for no reason. But if they stay in the effectiveness rates are what you state or slightly better.

      There are also probably girls who remove it. We also don’t know if those girls are still teens when they get pregnant again. For example someone could give birth at 18, get an IUD through this program and then 4 years later when their in their 20′s, finished with college and married, get pregnant again. Wouldn’t they still be included in this data? They were given the IUD as part of this program and I doubt they stop keeping track of the girls just cause they’re not teens anymore.

    • Jessica

      They could be having them removed because of side affects too. I had an Implanon implant for a couple of years & while I had no problems, there are several reviews that didn’t have positive experiences.

    • http://www.pileofbabies.com/ Meredith Bland

      Sorry that wasn’t clear!! Those are women who chose to get their IUDs removed because they wanted more kids.

    • Kylie

      The number of people who will remove them themselves is shocking. I think a lot more education into the side effects of pulling the string yourself needs to be done. I know seemingly intelligent people who have removed theirs for different reasons (I put a lot of emphasis on the word “seemingly”!).

  • shel

    Similar programs have been done in not necessarily teenagers, but in low income populations… though I think the pill/ring etc. might have been options as well… though I think the IUD was the main contraception offered… and all at low cost. And you know what? Less pregnancies!! Shocking!!
    I don’t understand why this is taking so long to catch on. I mean, I do… but it’s ridiculous. Take your religious whatever and conservative belief whatevers and practice them independently, let other people do what’s best for them. Contraception reduces the need for abortion, it reduces the amount of unwanted and poorly supported pregnancies/children. It SAVES money. But because people don’t understand science and decided that potential unborn babies are what they want to be self righteous about, the population as a whole gets screwed.
    I know I’m preaching to the choir here… but damn… this frustrates me so much.

    • Andrea

      I’m actually thinking it has very little do with right wing morals and a whole lot to do with right wing “I don’t wanna pay for it” attitude.

    • brebayVadgeBadge

      Because cyclical welfare is so much cheaper…

    • Andrea

      Of course. There is also what Nikki said above

    • nikki753

      I think it mostly comes down to a “Babies are your punishment for being a slut.” attitude.

    • AE Vorro

      Yes, that’s certainly a part of it.

    • Andrea

      I think that’s a huge part of it for sure.

    • Rachel Sea

      “I don’t wanna pay for it” by people who failed math. The thing that kills me when they claim it’s too expensive is that unwanted babies born to parents in poverty are 87 hojillion times more expensive than an IUD.

    • Andrea

      They just don’t see things like that. The way they see it women shouldn’t have sex. PERIOD. If we don’t pay for birth control then they won’t have sex.
      When I type it I looks ridiculous, but that’s the way I think. The corollary is if they are having sex, then they can pay for their birth control.
      Seriously, it is amazing how narrow sighted they are.

    • ted3553

      when a woman says that she is having sex and will probably continue to have it and all a lawmaker does is put their fingers in their ears and pretend they can’t hear her, we’ll get nowhere.

    • Kat

      I will never, as long as I live, understand people who fight against birth control and call themselves conservatives. For exactly the reasons you stated above. Fewer abortions, which I think we can all agree is a good thing. Lower medical costs that are often passed on to the taxpayers. Less of a chance of unplanned pregnancies turning into babies who use WIC and SNAP. An IUD is, I don’t know, about a bazillion times cheaper than a child born to an uninsured mother who cannot afford to feed it. And here I am both generalizing and presenting the worst case scenario, but it exists and happens every day.

      Thanks to reforms put in place by the ACA, my IUD was $25. It would have been free but my doctor likes to do sonograms to ensure they’re placed properly so I had to pay a co-pay. Previously, according to Dr. Google, it wold have cost between $500-$1000. So, seriously, thanks Obama.

  • Shelly Lloyd

    It is only for girls who have had a baby though? Isn’t there some way a teen could get something before they have the first baby?

    • NotTakenNotAvailable

      I believe so, but obviously they’d have to take the initiative to seek out medical advice. Meredith’s point simply seemed to be that hospitals are now telling teen mothers, “Hey, since you’re in the hospital already…”

    • http://wtfihaveakid.blogspot.ca/ jendra_berri

      With the cervix being all– I don’t know what the word would be– loosey goosey, it might be just the time to get it done too.

    • Jayamama

      I’m totally using that the next time I have a baby, just to see the look on my husband’s face. “Hey, honey, I think my cervix is all loosey goosey now.”

    • Kylie

      Some doctors are reluctant to give IUD’s to people who haven’t given birth before. There are more complications and speaking from experience, it hurts like a MOFO. After giving birth, I didn’t feel a thing ;-)

      But yes, you’d think that contraceptive that you essentially “forget” about for 5 years would be way more effective.

    • Katherine Handcock

      One of my friends went to have an IUD put in after her first child…down the hall was another woman who was there for the same thing and having it done first. She apparently screamed like she was being slaughtered. My friend was terrified, and when the doctor appeared and saw her white face, she said, “Oh, no, I didn’t know you’d be able to hear her! It’s not as bad as that for women who’ve given birth.” And indeed, my friend’s experience was fine.

    • kittymom

      I haven’t had kids, and I’ve had two put in (once for birth control, then removed to try to get pregnant, then circumstances changed and I needed another). No, it doesn’t not feel good, but it’s not that bad, honestly. The second one hurt more (I think it was a “bad time” in my cycle) but I didn’t even have a hand to hold and I didn’t make a peep.
      TL;DR- I’ve had two inserted without having kids and it’s really not that bad. I imagine better than labour…

    • jo

      Even still, I think it for most people it would be a cake walk compared to the alternative…giving birth

    • http://wtfihaveakid.blogspot.ca/ jendra_berri

      Vaginally? This doesn’t seem like something that would apply to a c section mom, though it would be nice to know if it did.

    • Katherine Handcock

      Good point! I don’t know if it’s a result of general changes due to pregnancy or strictly due to vaginal delivery.

    • Jayamama

      If the mom had a scheduled C-Section without labor, then you’re probably right. But if she experienced some labor and dilation, then it probably wouldn’t be quite as bad, though I’m sure actually having the baby go through the cervix is what they mean by “women who have given birth.” And, as someone else said, getting it placed is nothing compared to actually giving birth!

    • CollateralDamage

      I have no kids, and I had an IUD placed about four years ago. I wish I could have taken some reeeeally good pain meds first. :( The thing that got me through it was looking at the nurse and asking “This doesn’t hurt nearly as much as childbirth, right?” and having her confidently affirm.

    • Andrea

      The article said they are also doing the implants. I wish there was a way to reach teens before they get pregnant and inform them of that (presumably free) option.

  • NonMonogaMommy

    I’ve been told that IUDs are only recommended for monogamous women, because of the IUD/STI/PID/infertility connection (http://www.aafp.org/afp/1998/1201/p2077.html). It seems like a risky leap to trust that teenagers with a history unplanned pregnancies are nontheless practicing monogamy.

    Preventing unintended teen pregnancies is fantastic, but future fertility is a high price.

    • Mel

      I am offended by your assumption that teens with a history of unplanned pregnancy are not monogamous. Pregnancy is the result of sex. Just once, and not a bunch of sex with every random guy in town. Comments like yours feed into the stereotype that all teen moms are irresponsible sluts. You should no more assume that any teen with a history of unplanned pregnancy is not practicing monogamy than any woman of ANY age with a history of unplanned pregnancy.

    • http://www.nonmonogamommy.com/ NonMonogaMommy

      That’s a completely valid point, and I regret any slut-shaming gleaned from my comment. It wasn’t my intention to imply that teen parents are more promiscuous than teens who have sex and avoid pregnancy. What I was thinking of was brain development studies in teenagers, and issues of judgment and impulse control.

      There are plenty of sexual situations -for children AND adults- where a cocktail of passion and peer pressure can blank safer sex practices. What I’m trying to point out is that the odds of making a healthy, self-protective choice in those moments are lower for a teen than an adult. To quote researcher Silvia Bunge regarding adolescent judgment, “If your friend says, ‘Hey, let’s try this drug, it will be fun,’ you might not be able to use the information you know about the possible negative consequences to resist.” ( http://www.berkeley.edu/news/media/releases/2008/10/16_neurolaw.shtml ) I’m all in favor of giving IUDs to teenagers, but I don’t want them to get the impression it’s a panacea, and I -do- want the IUDs to come with lots of condoms and regular STI testing.

      Also, as you might intuit from my screen name, I’m a practitioner and proponent of ethical nonmonogamy; nothing wrong in my world with having multiple partners. My desire here is to keep sexually actively teenagers as safe as possible while they explore and screw up and learn. Giving girls and women inexpensive IUDs is great, but we need to also shower them with condoms, and remind that even when -they- choose monogamy, their partners may not.

  • nikki753

    1. 20% of the new moms that chose short term birth control are pregnant again a year later? Holy shit.
    2. Duhhh. Of course this works better. Now let’s offer this in 49 more states and not just for people who have had babies (true, IUDs are often not recommended before having any babies but there are other long term methods to offer).

  • Jessica

    When I was in college, I did an internship at an alternative high school in parental education working with teens that were pregnant or already parents working toward their high school diploma or GED. This was in Illinois, but I know several of our girls chose a long term birth control from the local health department for free or a greatly reduced cost. I’m wondering if that was a special program, or just something that wasn’t widely known. A lot of our job was helping the students find & gain resources they qualified for.

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