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The United States has the highest rate of teen pregnancy and births in the western industrialized world, with more than 750,000 women ages 15 to 19 years old becoming pregnant each year. About 80% of these pregnancies are unintended and occur in unmarried teens. Of these, about 30% end in abortions, 57% in live births, and 14% in miscarriage.

In the United States, oral contraceptive pills (OCPs) remain the most common form of hormonal contraception for adolescents and reproductive-age women. (Technically, these drugs are dispensed as tablets, but the term “pill” is so closely linked with oral contraception that it will be used in this article.) Although the failure rate of the OCP is 0.3 per 100 women-years with ideal use, typical use failure rates, particularly for adolescents, are much higher (3 to 8/100 women-years). Contraception efficacy for the most common...

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