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The Future of Birth Control

An early look at a Pacific Standard story that's currently only available to subscribers.
(Photo: JPC-PROD/Shutterstock)

(Photo: JPC-PROD/Shutterstock)

Why IUDs are poised to become the future of birth control: They’re the most effective method—perhaps because they’re the most empowering.

Nora Caplan-Bricker's Pacific Standard story is currently available to subscribers and will be posted online on Wednesday, September 2nd. Until then, an excerpt:

After decades out of favor, the intrauterine device is making a comeback. This small, T-shaped form of birth control, which is placed in a woman’s uterus and prevents pregnancy for between three and 10 years, has carried a stigma in the United States ever since the 1970s, when one notoriously flawed model, the Dalkon Shield, caused septic miscarriages and infertility in thousands of American women. But now, health-care providers are trumpeting the safety—and efficacy—of the models currently on the market. The American College of Obstetricians and Gynecologists concluded as early as 2005 that IUDs and hormonal implants (which are inserted in a woman’s arm) are the most reliable forms of birth control, and should be among the top options offered to all women; the American Academy of Pediatrics released a similar recommendation in 2014.

Public health officials have good reason to be excited. Unlike more popular types of birth control—condoms and pills, the patch and the ring—these long-acting devices don’t require women and girls to fill a prescription, or to bring along protection every time they have sex. Accordingly, these devices are far more effective at preventing pregnancy. IUDs fail less than one percent of the time. The benefits of widespread adoption are potentially huge: When a privately funded experiment made IUDs and implants available for free across the state of Colorado, both the teen birth rate and the abortion rate dropped by about 40 percent.

Despite some recent buzz about long-acting birth control, though, only about nine percent of American women are actually using IUDs or implants—and perhaps only 50 percent have even heard of them. Here are five studies that explain why public health experts are so committed to driving those numbers up—and what needs to happen for them to succeed.

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