Here's What Happened to Teen Girls After St. Louis Started Providing Free Birth Control


The news: Forget abstinence-only contraception: Teens who were educated about methods of birth control and who received free contraception were far less likely to get pregnant or have an abortion, according to a new study in the New England Journal of Medicine.

Fourteen hundred teens took part in a St. Louis program called the Contraceptive CHOICE Project, of whom nearly 3 in 4 received either an intrauterine device (IUD) or a contraceptive implant in their arm that released the hormone progestin. Healthline reports that these highly effective, long-term contraceptive methods are usually only chosen by around 5% of teens. Most who do use contraception use short-term methods like condoms or birth control pills.

After two years, two-thirds of the teens who received the longer-lasting birth control methods were still using them, compared to just one-third of the teens using alternate methods. Of the 500 teens who were between the ages of 14 and 17 in the program overall, about half had previously had a pregnancy, while another 18% had previously received an abortion.

Among the 15-to-19-year-olds in the Contraceptive CHOICE Project, the annual pregnancy rate fell to 3.4%, just a fraction of the national average of 15.9% among sexually active teenagers. The birth rate was 1.9%, compared to 9.4% in the same general population. They also got fewer abortions: Fewer than 1% of the Contraceptive CHOICE Program participants had an abortion each year. Among other teens who are sexually active, that rate is above 4.2%.

"The CHOICE Project removed three important barriers for teens ... education, access and cost," said Gina Secura, who directs the CHOICE Project. "The simultaneous removal of these common barriers ... resulted in much lower pregnancy rates. By simply removing one barrier, we probably would not have seen the same results."

Why it matters: This isn't an isolated result. A similar program by the Colorado Family Planning Initiative provided low-income women with IUDs at 68 clinics everywhere across the state, helping trigger an astonishing 40% drop in teen birth rates from 2009 to 2013. The abortion rate in the counties with operating clinics dropped 35%, and the program is estimated to have saved around $42.5 million in 2010 alone.

Compare that to abstinence-only programs promoted by conservatives, on which SEICUS reports Congress spent around $1.5 billion over the last two and a half decades. A 2007 study by the National Campaign to Prevent Teen and Unplanned Pregnancy found "strong evidence that abstinence-only-until-marriage programs do not have any impact on teen sexual behavior." SEICUS writes that state analysts have found serious programs in abstinence-only programs in Pennsylvania, Texas, Arizona, Kansas, California, Minnesota and Maryland.

In Texas, one of the study's investigators concluded "we didn't see any strong indications these programs were having an impact in the direction desired ... these programs seem to be much more concerned about politics than kids, and we need to get over." In Minnesota, the number of students in junior high school who admitted to sexual activity doubled among those who attended abstinence-only programs at three schools in 2001 and 2002.

Reproductive health advocates have been saying for years that the best way to prevent abortions and promote sexual health is robust sex ed and easy access to birth control. The latest study in St. Louis is just more proof that adults need to get over their hangups on teen sexuality and give them the tools they need to make smart decisions, not just try to convince them not to have sex. Because let's be honest — would that have worked on you?