Changes in use of long-acting contraceptive methods in the United States, 2007-2009.

OBJECTIVE To examine trends in the use of long-acting reversible contraceptive (LARC) methods-the intrauterine device (IUD) and implant--and the extent to which these methods have replaced permanent sterilization and less effective short-acting methods. DESIGN We tabulated data from female survey respondents overall and by demographic subgroups. We performed t-tests of the differences in the proportions of female contraceptors using LARC in 2007 and 2009. We also looked at use of LARC, sterilization, other methods, and no method among women at risk of unintended pregnancy. SETTING In-home survey. PATIENT(S) All female respondents to the surveys. INTERVENTION(S) None. MAIN OUTCOME MEASURE(S) Current use of LARC methods in 2009, and change in use from 2007. RESULT(S) The proportion of contraceptors using LARC increased significantly from 2.4% in 2002 to 3.7% in 2007 and 8.5% in 2009. The increase occurred among women in almost every age, race, education, and income group. Among women at risk of unintended pregnancy, increases in LARC use more than offset decreases in sterilization. CONCLUSION(S) LARC methods (primarily IUDs) are contributing to an increase in contraceptive effectiveness in the United States.

[1]  P. Murphy.  Contraceptive technology 1984–198512th Revised edition. By Robert A. Hatcher, md, et al. New York: Irvington Publishers, 1984. 304 pages. $12.95, softcover , 1985 .

[2]  ACOG Practice Bulletin no. 109: Cervical cytology screening. , 2009, Obstetrics and gynecology.

[3]  J. Trussell,et al.  Determinants of and disparities in reproductive health service use among adolescent and young adult women in the United States, 2002-2008. , 2012, American journal of public health.

[4]  D. Hubacher.  The checkered history and bright future of intrauterine contraception in the United States. , 2002, Perspectives on sexual and reproductive health.

[5]  Alwyn Smith,et al.  Cervical cytology screening , 1988, British medical journal.

[6]  L. Finer,et al.  Characteristics of Women in the United States Who Use Long-Acting Reversible Contraceptive Methods , 2011, Obstetrics and gynecology.

[7]  J. Guillebaud,et al.  Medical eligibility criteria for contraceptive use , 2018, Advanced Health Assessment of Women.

[8]  L. Finer,et al.  Unintended pregnancy in the United States: incidence and disparities, 2006. , 2011, Contraception.

[9]  L. Finer.  Unintended pregnancy among U.S. adolescents: accounting for sexual activity. , 2010, The Journal of adolescent health : official publication of the Society for Adolescent Medicine.

[10]  J. Trussell,et al.  Cost effectiveness of contraceptives in the United States. , 2009, Contraception.

[11]  J. Peipert,et al.  The Contraceptive CHOICE Project: reducing barriers to long-acting reversible contraception. , 2010, American journal of obstetrics and gynecology.

[12]  D. Clifton,et al.  Population Reference Bureau. Family planning worldwide 2008 data sheet. , 2008 .

[13]  P. Briss.  U S. Medical Eligibility Criteria for Contraceptive Use, 2010. , 2010, MMWR. Recommendations and reports : Morbidity and mortality weekly report. Recommendations and reports.

[14]  H. Peterson,et al.  Poststerilization regret: findings from the United States Collaborative Review of Sterilization. , 1999, Obstetrics and gynecology.