Jacobs Institute of Women's Health
Long-acting reversible contraceptive (LARC) methods – specifically, intrauterine devices (IUDs) and subcutaneous hormone-releasing implants – demonstrate great potential in reducing unintended pregnancy. Although LARC methods have had a rocky history in the US and use rates have remained low here in comparison to other countries where the methods are available, there has been a significant increase in uptake of newer LARC products in recent years. Researchers have identified this change as a likely contributor to the declines seen in unintended pregnancy, abortion, and teen pregnancy rates.
Decades of research have shown that current LARC methods are highly safe and effective, yet research has identified many barriers that may prevent a woman who chooses a LARC as the contraceptive method that best meets her needs and preferences from getting it. These include inadequate provider knowledge and training, lack of awareness and education among potential users, and financial and health system barriers. There are also, however, encouraging research findings from assessments of interventions designed to reduce these barriers.
Despite the recent advances, some barriers to full, voluntary, and successful use of LARC methods remain but have the potential to be addressed through policy: implementation of insurance coverage for LARC insertion and removal, both under private plans and public programs, such as Medicaid; development of clinical performance measures for clinicians and/or health centers; and establishment of practices that ensure confidentiality and non-coercive provision of LARC methods, particularly for vulnerable populations.
Strasser, Julia; Borkowski, Liz; Couillard, Megan; Allina, Amy; and Wood, Susan, "Bridging the Divide White Paper: Long-Acting Reversible Contraception (LARC) in the United States" (2016). Jacobs Institute of Women's Health. Paper 7.
Key Points for Policymakers
LONG-ACTING REVERSIBLE summary tables.pdf (113 kB)
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History of Long-Acting Reversible Contraception (LARC) in the United States
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