Offer youth intrauterine methods of contraception first, paediatricians advise
OTTAWA — Intrauterine methods of contraception should be the first-line birth control option for youth, according to a new position statement from the Canadian Paediatric Society (CPS).
The statement, released today, reviews the benefits and risks of each method of birth control and provides health care providers with practical strategies to help youth choose the most suitable method of contraception.
“The personal, health care and social costs of a single unintended or mistimed pregnancy are substantial,” said Dr. Giosi Di Meglio, a member of the CPS Adolescent Health Committee, and an adolescent medicine specialist at The Montreal Children’s Hospital. “As health care providers, we must reinforce safer protective practices for youth wishing to avoid pregnancy by recommending contraceptives in order of effectiveness, with intrauterine methods of birth control as the most reliable option.”
An intrauterine device (IUD) or system (IUS) is a small (often T-shaped) device placed inside the uterus by a health care provider to prevent pregnancy. Both IUDs and IUSs act continuously over the course of several years, but can be removed at any time by a health care provider.
IUDs are more than 99 per cent effective. Hormone pills and condoms are 91 and 82 per cent effective, respectively, but only when used properly. IUDs are hormone-free, while IUSs have a small amount of hormones.
The CPS statement also recommends that health care providers reduce common barriers to initiating and continuing birth control use.
“Providing birth control without a PAP or pelvic exam, offering year-long prescriptions and encouraging youth to start contraceptives right away, rather than waiting for their next period, all make it more likely for youth to access and use contraception,” said Dr. Di Meglio.
The CPS statement also advises providers who care for youth to:
- discuss sexual health, fertility, family planning and contraception with all youth starting early in adolescence, ideally before they become sexually active;
- adopt a collaborative approach that empowers youth to make informed decisions about their birth control options, weighing the benefits, risks, side effects and suitability of each method with each patient;
- encourage youth to always use condoms, regardless of the method of birth control, to prevent sexually transmitted infections;
- inform all youth about emergency contraception as a back-up method of preventing pregnancy.
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About the Canadian Paediatric Society
The Canadian Paediatric Society is a national advocacy association that promotes the health needs of children and youth. Founded in 1922, the CPS represents more than 3,300 paediatricians, paediatric subspecialists and other child health professionals across Canada.
Last updated: May 30, 2018