Birth Control and Sex Ed: What Works Best?

Medically Reviewed by Brunilda Nazario, MD on April 22, 2021

Teen pregnancies are at an all-time low in the U.S. Experts aren’t sure what’s caused the numbers to drop in recent years. But comprehensive sexual health education that touches on a wide variety of topics may play an important role.

The dip in teen births may be due to teens staying away from sex or because more teens now have more access to birth control when they’re sexually active than they did in previous years.

But not all sex ed programs taught across the U.S. are equally effective. They vary from school to school and differ based on where you live. Some programs focus on an abstinence-only approach and leave out key topics like birth control options. Research shows that it’s more effective to cover both in a comprehensive sex ed program.

Birth Control in Sex Ed

One large-scale study found that teen girls who had comprehensive sex education before they became sexually active were more likely to use some type of birth control the first time they had sex. They were also more likely to choose the more effective birth control methods, like the long-lasting IUD or an implant.

About 38% of high school students have ever had sex, with nearly 9% having had sex with four or more partners, according to the CDC’s 2019 High School Youth Risk Behavior Survey.

Other CDC data show that among teens ages 15-19, 78% of females and 89% of males said they had used a form of contraception the first time they had intercourse. Most used condoms. Those who had sex for the first time when they were at least 15 years old were more likely to use contraception than those who first had intercourse at age 14 or younger. That data, published in May 2020, came from surveys done from 2015 to 2017.

What Is Comprehensive Sex Ed?

It’s a form of sexual health education that covers a wide variety of topics that are:

  • Medically accurate
  • Evidence-based
  • Age-appropriate
  • Culturally relevant

The curriculum should include these things, according to the American College of Obstetricians and Gynecologists:

  • Birth control (all available contraceptives, including long-lasting and reversible)
  • Benefits of delaying sexual activity
  • Sexually transmitted infections (STIs)
  • Reproductive development
  • Consent
  • Sexual expression, gender identity
  • Healthy relationships
  • Recognizing and preventing sexual violence

Besides giving information, the comprehensive curriculum also outlines that programs should put adolescents in touch with the right health services and a supportive environment at school. This can then help teens learn how to reduce risky sexual behaviors and prevent unintended pregnancies.

One study found that teaching about birth control options through sex ed did not raise the risk of sexual activity among teens. In fact, young adults who get comprehensive sex education are less likely to end up with unintended pregnancies than those in programs that choose to talk about an abstinence-only approach.

The State of Sex Education in the U.S.

Almost all states in the U.S. teach sex education. But less than half of U.S. public high schools (43%) and only about 18% of middle schools teach quality comprehensive sex education, according to a 2018 report.

In 30 states and Washington, DC, public schools are required to teach sex education and HIV information. But 36 states and Washington, DC, allow parents to have their children opt out of sex education.

Between 2011 and 2013, over 80% of teens ages 15-19 got some form of sex ed that covered some of the important topics such as HIV, STIs, or how to say no to sex. But only 55% of young men and 60% of young women were taught about birth control.

Non-comprehensive sex education may also not cover skills required for birth control, like how to put on a condom each time you have sex. In 2014, only about 35% of the U.S. schools that provided sex education taught students how to correctly use a condom, the CDC reports.

Experts say just teaching abstinence isn’t effective enough. Research shows that comprehensive sex education that includes both abstinence and the use of birth control, along with other important topics on sex, may work well together. It can help teens delay sex longer, lead to healthier relationships, avoid STIs, and prevent unintended pregnancies.

More research is needed to get more up-to-date data to truly understand the how sex education impacts birth control knowledge and the ability to avoid unintended pregnancies.

In the meantime, if you’re a student who’s unsure about anything regarding sexual health, including birth control options, ask your parents or doctor about it. They can guide you to options that may work best for your health. This can help reduce your chance of having an unintended pregnancy or an STI.

Show Sources

SOURCES: “Sex and HIV Education.”

CDC: “What Works: Sexual Health Education,” “About Teen Pregnancy,” “High School Youth Risk Behavior Survey, 2019,” “Results from the School Health Policies and Practices Study 2014.”

Journal of Adolescent Health: “Abstinence-only and comprehensive sex education and the initiation of sexual activity and teen pregnancy,” “Changes in Adolescents’ Receipt of Sex Education, 2006-2013.”

American College of Obstetricians and Gynecologists: “Comprehensive Sexuality Education.”

Contraception X: “Sex education and contraceptive use of adolescent and young adult females in the United States: an analysis of the National Survey of Family Growth 2011-2017.” “Sex education: Why an abstinence-only approach is problematic.”

American Journal of Preventive Medicine: “The Effectiveness of Group-Based Comprehensive Risk-Reduction and Abstinence Education Interventions to Prevent or Reduce the Risk of Adolescent Pregnancy, Human Immunodeficiency Virus, and Sexually Transmitted Infections.”

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