Strategies to prevent unintended pregnancy: increasing use of long-acting reversible contraception

Abstract

LARC methods-copper intrauterine devices (IUDs), progestogen-releasing intrauterine system and injectable and implantable contraceptives-are safe and effective contraceptive options (unintended pregnancy rates with typical versus perfect use: 0.05-3.0 versus 0.05-0.6%) that are appropriate for a wide range of women seeking to limit or space childbearing. Despite their safety and efficacy records, these methods remain underutilized; injectable and implantable methods are used by an estimated 3.4% and intrauterine methods by 15.5% of women worldwide. LARC methods require no daily or coital adherence and avoid the adverse events and health risks of estrogen-containing contraceptives. The copper IUD and progestin-only injections and implants have been shown to be more cost-effective than more commonly used methods, such as condoms and the pill (5-year savings: $13,373-$14,122, LARC; $12,239, condoms; $12,879, pill). Women who are considering use of LARC methods should receive comprehensive contraceptive counseling, as women who receive counseling before use demonstrate higher rates of after-use method satisfaction, continuation and acceptance than those who do not.

Prevalence and Determinant Factors of Long Acting Contraceptive Utilization among Married Women of Reproductive Age in Adaba Town, West Arsi Zone, Oromia, Ethiopia

“…LACs may be a good option for some of them, given their reproductive intentions, but they may not be using one because of lack of knowledge, access or other factors [4]. Long-acting reversible contraceptives methods (LACs) have been under-utilized despite their effectiveness and low cost [6].…”

Post Abortion Women’s Perceptions of Utilizing Long Acting Reversible Contraceptive Methods in Uganda. A Qualitative Study

“…Unintended pregnancy remains a global public health problem despite the availability of effective contraceptives [1]. The burden of unwanted pregnancy is highest in low and middle income countries (LMIC) where one-third of all pregnancies are unintended [2].…”

“…In Sub Saharan Africa the unmet need for contraception is very high leading to high prevalence of unwanted pregnancies [3]. This unmet need for family planning is a result of poor knowledge, inadequate logistics, lack of contraceptive access to women and limited availability of skilled health care providers who can provide some family planning methods [1]. A substantial proportion of unplanned pregnancies also occur due to contraceptive method failure [4].…”

Mulheres com vulnerabilidade sexual: anticoncepção reversível de longa duração pode ser a solução?

“…Contudo, sempre houve preocupação com os efeitos em longo prazo da contracepção hormonal combinada, principalmente quanto aos riscos cardiovasculares, como o tromboembolismo e a disfunção endotelial. Por isso, muitos investigadores sugerem o emprego da anticoncepção reversível de longa duração, LARC (Long-acting reversible contraception, sinonímia no inglês), para mulheres que escolhem ou necessitam de anticoncepção prolongada [1][2][3] . Os LARCs incluem o implante subdérmico de etonorgestrel, o sistema intrauterino de levonorgestrel e o dispositivo intrauterino (DIU) de cobre.…”

“…1 edMund C baraCat 1 Após 50 anos do surgimento da pílula contraceptiva hormonal combinada, houve aumento da liberdade sexual e ganho de outros benefícios, como regularização e redução do fluxo menstrual, melhora do hiperandrogenismo cutâneo, da tensão pré-menstrual e da dismenorreia. Contudo, sempre houve preocupação com os efeitos em longo prazo da contracepção hormonal combinada, principalmente quanto aos riscos cardiovasculares, como o tromboembolismo e a disfunção endotelial.…”