The American College Of Obstetricians And Gynecologists (ACOG) has issued new guidelines to endorse IUDs and implants as first-line birth control options for teens. Despite widespread availability of condoms and birth control for women at very low cost (31-year-old Georgetown law students disagree, of course, they think the government should pay for it so they can instead spend $50,000 a year becoming lawyers), over 80 percent of teen pregnancies are unintended, they note, and so something more permanent should be used.

And advocates use anecdotal evidence to advance the idea that current birth control does not work and that other doctors are to blame for some of the problem. In a story worthy of Michele Bachmann, ABC News treats us to a Planned Parenthood claim that a young woman had her IUD removed when she broke up with her boyfriend because her doctor said IUDs could only be used by women in monogamous relationships. Supposedly, the woman became pregnant and had an abortion. At least they didn't claim she became retarded from the lack of government-sponsored birth control. That would just have been silly.

In the past, IUDs were a no-no, due to rampant problems with infertility issues (well, that is birth control at least), pelvic inflammatory disease and spontaneous septic abortion. IUDs get invoked more in birth control scare stories than thalidomide gets invoked about genetically modified food.  So a new endorsement has to be making Bayer, maker of the Mirena IUD, thrilled.  It is a de facto subsidy waiting to happen. Too late for AH Robins, they went bankrupt over their IUD lawsuits.

Most odd is that the ACOG is recommending making these a first-line choice for 15-year-old girls  even though no one in that organization can be quite sure how they work.  All we know is that plastic in the uterus is foreign and so the uterus spends its time sending in white blood cells kill it - sperm gets caught in that attack, preventing pregnancy.  I am not knocking doctors for not knowing how biology works, electromagnetics is hard too.  No one can really define a magnetic field yet it is the basis for a $500 billion semiconductor industry.  It just seems strange to recommend these for developing bodies, just like birth control pills have lots of different effects on different women.  These white bloods cells are in overdrive all of the time. I guess gynecologists are okay with that,

Am I being anti-science in urging parents of teenage girls to use some caution about embracing IUDs again, despite the fancy name of the endorser?  No, doctors themselves often don't use evidence for making decisions and this could be no different.  Beta-blockers have never been shown to help patients right after a heart attack but doctors recommended it anyway, until the government stopped paying for it.  And the public knows what doctors seem to ignore, that antibiotics for an ear infection often do more harm than good.  Arthroscopic surgery for knee arthritis is a $3 billion a year business but is no better than physical therapy. Brachytherapy, partial-breast treatments for cancer, went up 1000% over a 5-year period despite any evidence it works. But the government started paying for it and so it got used.

The ACOG is not all that concerned about an evidence basis for their recommendation because there is a shocking lack of evidence basis in a lot of medicine. 

Putting something in a teenager just because an employee of Planned Parenthood has horror story anecdotes published by ABC is not critical thinking.