Unintended pregnancies pose a significant public health risk and account for 45% of all pregnancies in the US, with 41% caused by inconsistent use of contraceptives. This highlights the current need for modern contraception with enhanced compliance. The Practice Bulletin from the American College of Obstetricians and Gynecologists indicates long-acting reversible contraceptives (LARC) are the most effective reversible contraceptive methods because women can have long-term effective contraception with a single intervention. Yet, fewer than 15% of women choose a traditional LARC and 20-30% of women have their IUD or implant removed within one year.



1. For patients that are hesitant or decline traditional LARCs, what additional/alternative birth control options could be considered?

2. What are the reasons why some patients are more likely to switch to a long-lasting alternative birth control?



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Guttmacher Institute. Contraceptive Use in the United States Fact Sheet, July 2018.



ACOG Practice Bulletin: Long-Acting Reversible Contraception: Implants and Intrauterine Devices, Number 186 (https://www.acog.org/clinical/clinical-guidance/practice-bulletin/articles/2017/11/long-acting-reversible-contraception-implants-and-intrauterine-devices)



CDC US Selected Practice Recommendations (US SPR) for Contraceptive Use, 2016 (https://www.cdc.gov/reproductivehealth/contraception/mmwr/spr/summary.html?CDC_AA_refVal=https%3A%2F%2Fwww.cdc.gov%2Freproductivehealth%2Fcontraception%2Fusspr.htm)



Curtis KM, Tepper NK, Jatlaoui TC, Berry-Bibee E, Horton LG, Zapata LB, et al. U.S. medical eligibility criteria for contraceptive use, 2016. MMWR Recomm Rep 2016;65(RR-3):1–103. (Level III) Kavanaugh ML, et al. F&S Reports, 2020, 1(2):83-93, https://www.fertstertreports.org/article/S2666-3341(20)30038-6/fulltext.



Diedrich JT, Zhao Q, Madden T, et al. Three-year continuation of reversible contraception. Am J Obstet Gynecol, 2015;213:662.e1-8.</sub>