Only about 5 percent of U.S. women use long-acting contraceptives, far fewer than in other developed countries. Peipert said insurance hasn’t always covered the higher upfront cost to insert them, even though years of birth control pills can add up to the same price.
Yet three-quarters of his study participants chose an IUD or Implanon, and a year later 85 percent were sticking that choice — compared to about half who had initially chosen the pill, patch or other shorter-acting method.
Cost isn’t the only barrier. Doctors don’t always mention long-acting methods, maybe because of a long-outdated belief that IUDs aren’t for young women or just because they assume women want the most commonly prescribed pill.
That was the case for Ashley England, 26, of Nashville, Tenn., who enrolled in the study while in graduate school in St. Louis. She had taken birth control pills for years but struggled with a $50 monthly copay. She switched to a five-year IUD, and loves that she and her husband don’t have to think about contraception.
‘‘No one had ever presented all the options equally,’’ England said. ‘‘It’s not telling you what to do. It’s giving you a choice unhindered by money.’’
EDITOR'S NOTE — Lauran Neergaard covers health and medical issues for The Associated Press in Washington.