Teen birth rates have been going down for a while now but in one mountain west state -- Colorado --  they’ve gone down more than the rest of the nation. Could it be related to the national trend of kids having less sex or an attempt to make IUDs more accessible?

A little over a decade ago, Lynn Procell was going about her business at the Health Department Family Planning Clinic in Pueblo, Colorado when she got a strange phone call. It came "out of nowhere," she says.  

She laughs as she remembers it. "At the time the program manager and I were looking at each other real suspicious like 'what do they want?' you know? We were thinking 'what is it?'"

Little did she know, that call would change her work dramatically.

It was around 2007 and teen births looked like they were trending upward again. Procell was worried. She says the clinic was trying to educate teens on sexual health and good choices but they didn’t have much money.

And that’s where that phone call comes in. On the other end of the line was a mystery donor who wanted to offer the state of Colorado roughly $28 million for an 8-year family planning initiative.

Procell says, "the state of Colorado felt really blessed to be able to get that amount of support."

As to the mystery donor, we’ll get to that later, but first, the $28 million. A big chunk of it was used to offer free or low cost IUD birth control to teens and Procell says that policy has made a real difference. Colorado’s teen birth rate has gone down by more than half and the decline has been even more significant in Pueblo County, where nearly 1 in 5 people live under the poverty line.

Procell says more women who were uninsured or underinsured were able to get contraception, specifically long acting reversible contraceptives, LARCs for short. It’s the category of contraceptives that include IUDs and these devices can cost several hundred dollars when paying out of pocket.

Procell says the funding came in around the same time that new research had been published on the efficacy and relative safety of LARCs for younger women.

“That changed a lot of things,” says Procell, “because we were able to not only talk to teens about this as a healthy option for you. The research is showing this is great, we've got these new products but we can also do it at no cost to any young woman."

Not everyone sees this as the perfect success story though. Joneen Mackenzie, founder of the Center for Relationship Education, says “the health department is doing their happy dance because they think they've done something wonderful.”

Mackenzie’s organization prioritizes fostering healthy relationships before contraception. “Having kids delay sexual debut is very important to me,” she says. Although she’s quick to add that she doesn’t like the word “abstinence.”

“If you say that word in my office you're fired,” she says. “It’s such a loaded word. It’s such a negative word.”

And she does acknowledge that contraceptives have played a role in reducing teen births in the state.

But she says the drop could be related to something else. She credits a significant part of the decline to kids having less sex, something that’s true across the country.  

That aside though, she just has issues with the program. Perhaps her biggest concern is that there may be young people out there getting contraception without conversation.

She asks, “why are we not coupling this LARC initiative with counseling services and educational services and skill building around healthy relationship development?”

But at the Pueblo Health Department Family Planning Clinic, Lynn Procell says the providers are doing pretty much that.   

“They aren't just there to hand out pills or stop a pregnancy, which is part of what we do,” says Procell. “But they're there to say ‘How's it going in your life. What else is going on. Can we help you and support you?’”

As to the mystery donor behind the funding for this Colorado program? Jody Camp who manages family planning for the state says she’s been asked by the anonymous donor for the past 8 years to keep it anonymous, “and that’s kind of what we do here.”

But the secret’s out. The grant came from billionaire Warren Buffet’s family foundation. It ended in 2016. Shortly after, Colorado legislators voted to provide additional family planning funds to the state. And Jody Camp says Colorado is keeping LARCs accessible to any teen who chooses them.

This story was produced by the Mountain West News Bureau, a collaboration between Wyoming Public Media, Boise State Public Radio in Idaho, Yellowstone Public Radio in Montana, KUER in Salt Lake City and KRCC and KUNC in Colorado.

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