Thursday, May 24, 2012

Choosing Contraception

The study below provides more evidence on the most effective form of birth control is Long Acting Reversible Contraception (LARC).  LARC includes Intrauterine Devices (a small device that is inserted into the cervix during an office visit) and Implantable Contraception (a small device inserted under the skin).  The advantage of these is that one procedure lasts 3-10 years.  No pills to take, things to insert, shots or anything else for the duration of the implant.  And, if you decide to get pregnant, they can easily be taken out.

Effectiveness of Long-Acting Reversible Contraception — NEJM

This research as others shows that they are more effective than other types of contraception (pills, patches, vaginal rings, etc.).  Here are some visual pictures to help everyone understand.  The numbers are approximate based on the data they show.  Each face below represents one woman over a year.  In the thousand women below, about 2 will have a pregnancy while on a LARC:

For women on a pill, patch or ring, about 48 more (smiley faces with the X's) will have a pregnancy:



LARCs also save money for the patient and the health care system.  There also have minimal side effects.  For instance, some women get increased bleeding with the IUD, but most get less or the same amount of monthly bleeding.

I talk to a lot of women about contraception, but many still choose a pill.  Why?  I'm interested in hearing the perspectives of women.  I think we all have the goal of reducing pregnancies that are not desired.

(Thanks to NNTonline.com for help creating the graphs.)

2 comments:

Lori said...

Because no one wants something implanted inside of her.

nycprochoicemd said...

Thanks for creating these graphs! I really like these representations.

Why don't more women choose LARC? I think there are lots of reasons. As Lori states, some people just don't like the idea of it. The high up-front cost is problematic for many women, who may lack coverage or be under-insured. Additionally, many women don't like the idea of having to go back to the doctor when it needs removal and prefer to be in complete control of when they start and stop using the method.

Even for women who want LARC, many doctors put up unnecessary barriers, especially for IUDs, and won't insert them in women who haven't had children or are teenagers.

I hope you keep talking to women about the real benefits of LARC.