Roughly one in four teens will become pregnant by age 20. Unintended pregnancies can be prevented with better and more consistent use of contraceptives.

Parents play a critical role in helping teens make healthy choices about sex. In fact, teens report that their parents have the greatest influence over their decisions about sex, even more than their friends. And those who talk with their parents are more likely to delay having sex until they are older.

While most parents want their kids to abstain from sex altogether, it is not a reality. Teens need to know how to be safe and responsible, which includes information about birth control options and safe sex.

It is important that both teens and parents educate themselves. Your child’s primary care physician is a great resource for questions about birth control.

There are many forms of birth control which are newer and more effective than simply using birth control pills. This is not your mother’s birth control.

The American Academy of Pediatrics provides an overview of birth control options, including advantages and disadvantages of each, for sexually active teens:

Long-acting reversible contraceptives (LARCs) are very effective long-term birth control options that can last from 3-10 years, depending on the method. This is a nice benefit for teens, as they don't have to remember to do something each day, week or month to stay protected from unintended pregnancy. It is recommended that teens use LARCs initially because they have the lowest failure rate.

Two types of LARCs (that must be inserted and removed by a doctor) include:

• Implant – A thin, flexible plastic implant (e.g., Nexplanon^®) that contains a hormone and is placed under the skin of the upper arm. It does not need to be replaced for three years.
• Intrauterine device (IUD) – A small, flexible, T-shaped device is inserted into the uterus. This can be performed in a short office visit. A hormonal IUD (e.g., Mirena^®, Kyleena^®, Skyla^®) does not need to be replaced for 3-5 years. A copper IUD (e.g., ParaGard^®) is hormone-free and does not need to be replaced for 10 years.

These are the safest and most effective birth control available. Less than one in every 100 women using an implant or IUD will get pregnant within the first year. Keep in mind that LARCs do not provide protection from sexually transmitted infections (STIs), so it is still important to use condoms.

Other birth control methods that are less effective include:

• The pill (daily) – A pill that contains hormones that prevent pregnancy.
• Skin patch (replaced each week) – A small adhesive patch (e.g., Xulane^®) worn on the skin that contains hormones that are slowly released into the body.
• Vaginal ring (replaced each month) – A flexible plastic ring (e.g., NuvaRing^®) that you insert into the upper vagina that releases hormones into the body.
• Injection/shot (every three months) – A shot (e.g., Depo-Provera^®) given in the upper arm or buttock that contains hormones that prevent pregnancy.
• Barrier methods (each time you have sex) – These include condoms, diaphragms, sponge and cervical cap.

The above forms are less effective because they rely on the teen to take these regularly, often on a daily basis, and require timely pharmacy refills and pick-ups. These forms have high failure rates, especially in the first year, mostly due to patients not taking the medicine appropriately.

The following methods are least effective and are not recommended as primary birth control for teens:

• Withdrawal – A man takes his penis out of a woman's vagina before he ejaculates.
• Fertility awareness-based methods (e.g., rhythm method) – Avoiding sex around the days you are most fertile.
• Spermicide – Foam, gel, cream, film or suppository is inserted into the vagina that make sperm inactive. Frequent use of spermicides may increase the risk of getting human immunodeficiency virus (HIV) from an infected partner.

Later in life, once a woman is finished having children or knows she doesn't want children, she and/or her partner may choose a more permanent birth control option to prevent pregnancy, such as female sterilization or male vasectomy.

Emphasize to your teen that using birth control and condoms together is the best way to prevent both pregnancy and STIs if they’re going to have sex.

Sometimes condoms break or teens may forget to use their method (e.g., condoms, the pill, diaphragm) properly. Doctors can prescribe emergency contraception for up to a few days after sex, but the sooner it is used the better it works.

Patients can also buy emergency contraception over the counter in most pharmacies without a prescription. Doctors may recommend that patients who are relying on condoms have these easily available at home in case they have unprotected sex or a condom failure.

Related blogs:

Teach your teen to be a teen first, a parent later

How to talk to your kids about sex