The last decade has seen a marked increase in use of long-acting reversible contraceptives (LARCs) among US women aged 15 to 44 years, according to a new data brief from the Centers for Disease Control and Prevention's (CDC) National Center for Health Statistics (NCHS).
LARCs include intrauterine devices (IUDs) and subdermal hormonal implants. IUDs were popular in the 1970s before concerns over safety led to a decline in use. However, with redesigned IUDs and approval of a 5-year contraceptive implant in 1990, LARCs are "gaining in popularity," note Amy M. Branum, MSPH, PhD, and Jo Jones, PhD, from the Reproductive Statistics Branch at the NCHS.
The researchers analyzed trends in LARC use among women 15 to 44 years old, using data from the National Survey of Family Growth.
They report that use of LARCs declined between 1982 and 1988 from 4.0% to 1.4%, held steady through 2002, and then increased nearly 5-fold in the last decade, going from 1.5% in 2002 to 7.2% in 2011 to 2013.
The percentage of women using LARCs remains highest among women 25 to 34 years old, with more than twice as many women in this age group using LARCs in 2011 to 2013 (11.1%) as women 15 to 24 years old (5.0%) and those 35 to 44 years old (5.3%).
LARC use is also now popular among women who have already had a child. Among parous women, LARC use increased more than twofold between 2002 (2.4%) and 2006 to 2010 (6.3%), and then rose nearly 70% from 2006-2010 to 2011-2013 (10.6%), the researchers say.
Patterns of LARC use varied by race and Hispanic origin during the last 30 years. LARC use decreased similarly among Hispanic, non-Hispanic white, and non-Hispanic black women between 1982 and 1988 and then held steady from 1988 through 1995, at which point LARC use patterns diverged. Between 2002 and 2006-2010, LARC use increased threefold among non-Hispanic white women and 4-fold among non-Hispanic black women, declining 10% among Hispanic women.
LARC use increased at a similarly high rate among Hispanic (129%) and non-Hispanic white (128%) women from 2006-2010 to 2011-2013 compared with a 30% increase among non-Hispanic black women during this period.
Compared with other contraceptive methods including oral contraceptives and the transdermal patch, LARC has shown "greater efficacy" in preventing unintended pregnancy among all women, Dr Branum and Dr Jones note in their brief.
"In addition, recent research has demonstrated that women opt for long-acting methods as their contraceptive method of choice when informed about these options; however, other research has demonstrated that barriers to LARC administration and use still remain," they point out.
"Trends in Long-acting Reversible Contraception Use Among U.S. Women Aged 15-44." NCHS Data Brief No. 188. Published online February 24, 2015. Full text
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