McMURRAY, Penn. (WOMENSENEWS)– Here at Peters Township High School in Western Pennsylvania the silence around the IUD is deafening.

Out of the 14 teens interviewed during school hours last spring, only two recognized the name of the contraceptive device.

“It’s something to prevent pregnancy, right?” asked sophomore Stephanie Wang, who started her junior year in August.

It’s not as though IUDs are off limits for teens here.

Free IUDs are available, just as much as any other contraceptive device, to all teenage girls living in Pennsylvania through the Maternal and Child Health Services Block Grant, said Wesley Culp, the deputy press secretary of the state’s Department of Health, in an email interview.

And the topic of teens using IUDs has been high in the news, partially due to a controversy in Colorado.

Between 2009 and 2013, Colorado received funding from a private donor to provide free IUDs to low-income women. The teen birth rate dropped by 40 percent during these years, according to the state’s public health department.

During the same time period, the national rate decreased by 25 percent. Abortion rates in Colorado also dropped 35 percent and there was a $42.5 million reduction in the health costs that come with teen births.

So why are the girls here unaware of a birth control method that the American Academy of Pediatrics recommends as a “first-line contraceptive choice for teens who choose not to be abstinent”?

The answer could be an absence of sex education.

Only 22 states and the District of Columbia require public schools to include sexual education in their curriculums. Pennsylvania is among the states that do not require sexual education to be taught in schools or for information about contraceptive options to be provided.

Abstinence-Only Programs

In 2010, more than $1.6 million in federal funds was provided to Pennsylvania for abstinence-only education programs.

Peters Township embraces these programs strongly.

“The scope and content of the topics we are permitted to address in our personal wellness classes do not include these various forms of birth control methods,” said John Vavala, a health and physical education teacher at the high school, in an email interview.

Yet the school’s nurse, Gail Kowalczyk, believes that “it should be a part of the sexuality education curriculum.”

Rising sophomore Mila Shadel is frustrated with the lack of sexual education she received in her freshman year. “All we learned was not to have sex,” she said in an interview conducted last spring during school hours. “That’s it. No methods of protection or anything.”

Amanda Smith, who will be a junior this year, agreed. “[My health teachers] stressed ‘abstinence is key,'” Smith said in a phone interview. “They never discussed options if we chose not to be abstinent. There’s definitely a stigma surrounding IUDs and birth control and it needs to be stopped; they need to accept that teens are going to have sex no matter what.”

Sneha Hoysala, a rising junior, noted that she felt uncomfortable talking about IUDs. “In school, it’s a very awkward thing to talk about. Birth control was never really brought up in class.” She said she learned about the IUD in conversations with friends.

Although they all have chosen to be abstinent in high school, the 14 girls expressed interest in using an IUD in the future once a reporter explained what it was.

“Although I’m not sexually active now, I would definitely use one if I am [active] in the future,” said Hannah Chaplain, a rising senior. “It sounds like a safe, long-term option that I would prefer over getting my tubes tied.”

Low Failure Rate

The failure rate of the IUD is between 0.2 and 0.8 percent compared to oral birth control’s 9 percent rate. Also, whenever a teen relies on an IUD, she doesn’t have to remember to take a pill every morning. IUDs also offer health benefits, such as treatment for excessive menstrual bleeding.

In 2014, out of the 3.2 million teenage girls using contraceptives, only 3 percent relied on an IUD while 53 percent used the pill, finds the Guttmacher Institute, a New York-based research group. Only a slightly higher percentage of adult women use this safe, effective form of birth control. America’s disenchantment with the IUD is not reflected across the pond; last year, 27 percent of women used one in Europe. In China, 41 percent of contraceptive-using women choose IUDs.

U.S. leeriness about the IUD can be traced back to the 1970s and ’80s. Shortly after Dalkon Shield released an IUD in 1971, reports of septic abortions, pelvic inflammatory infections, perforations of the uterus and other horrors came flooding in. By 1974, Dalkon Shield IUDs had caused 17 deaths. Yet the manufacturer, A. H. Robins, ignored the Food and Drug Administration’s suggestion to withdraw it from market.

In 1985, after the device caused 200,000 women physical injuries and miscarriages and provoked 300,000 lawsuits, A.H. Robins filed for bankruptcy. This crisis, largely reported by the media, greatly diminished the public’s trust in IUDs. By 1986, all IUD suppliers but one (Progestasert) had closed because of economic reasons.

The controversy around the original poorly developed IUD continues to taint its reputation, with 30 percent of health providers still wary of the device, according to the Centers for Disease Control and Prevention.

However, school nurse Kowalczyk fully endorses teen IUD use.

“IUDs got a bad rap after the health problems surrounding them in the 70’s,” she said. “But they are well researched and a safe option” for teens.