A birth control method that works more than 99 percent of the time is making a comeback after all but disappearing from America in the 1980s and 1990s.
The intrauterine device, or IUD, was the contraceptive of choice for 6.4 percent of American women aged 15-44 from 2011 to 2013, according to a report published Tuesday by the Centers for Disease Control and Prevention. Though the IUD, a small, T-shaped device implanted in the uterus, is far behind more popular methods of birth control like the pill or condoms, the share of women using one nearly doubled from 2006 to 2010, and is dramatically higher than the less than 1 percent of women who had IUDs in the mid-1990s.
The Guttmacher Institute reports that 51 percent of pregnancies are unplanned, and 95 percent of those result from not using or misusing birth control — like forgetting to take the pill every day at the same time. Wider adoption of the IUD would lead to fewer unplanned pregnancies and abortions, according to the American College of Obstetricians and Gynecologists.
“The more you can take the user out of the equation — if she so desires — the more you’ll be able to prevent unintended pregnancy,” said Megan Kavanaugh, a senior research scientist and public health specialist at the Guttmacher Institute, which studies reproductive health. “More and more people are jumping on the IUD and implant bandwagon because it seems like they might be potentially appropriate to cover for these long periods of a woman’s life when she needs coverage.”
Decades have passed since the Dalkon Shield scandal of the 1970s, when an estimated 200,000 women were injured, many became infertile and about 20 died from infections related to that IUD. But new, safer products started coming onto the U.S. market from the late 1980s through the current decade. Medical societies have adopted policies in recent years recommending physicians consider IUDs and other long-acting contraceptives for more types of patients, including women who’ve never had a child and teenagers. And word-of-mouth combined with advertising and marketing by IUD manufacturers has increased consumer awareness.
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That was Stevens’ experience, she said. “When I first heard about it was on a Mirena commercial. And I remember thinking, ‘God, I would love to have that.’”
The Affordable Care Act rule that health plans cover contraceptives without any copayments has been in place since 2012 — and benefited Stevens — but it has not been in place long enough to have had an effect yet, MacIsaac said. “That will happen. I just think it hasn’t happened yet,” she said. Removing the cost barrier to long-acting reversible contraceptives is bound to increase their use, she said.
Within a decade, MacIsaac predicts as much as one-quarter of American women will use IUDs, akin to the rates in European countries, where the Dalkon Shield’s problems didn’t frighten women and doctors away, she said.
“That’s what I hope, because it helps women balance all their different goals and opportunities and responsibilities,” MacIsaac said.
