MORE YOUNG WOMEN in the United States are becoming receptive to using long-acting reversible contraception (LARCs) to meet their birth control needs, according to a story covered by NPR earlier this month. Through a combination of patient education, community health outreach efforts, and funding on the state and federal levels, birth control proponents are combating the idea that LARCS are dangerous, ineffective, and damaging to reproductive health.
LARCS, which include the commonly-used intrauterine device (IUD) and birth control implant, are 99% effective at preventing pregnancy. Compared to alternative forms of hormonal birth control, they are proven to be “20 times more effective than birth control pills, the patch, or the ring,” according to research done by the American Congress of Obstetricians and Gynecologists. Unlike birth control pills, the patch, or the ring, where users are responsible for the proper administration of their birth control, LARCs can be implanted or inserted and then essentially forgotten about, taking human user error out of the equation. Despite this high rate of success, LARCS have a bad reputation that has prevented their widespread use. Only 10 percent of American women use LARCs, whereas other developed countries see percentages in the “high teens, maybe low 20s,” says Guttmacher Institute senior research scientist Megan Kavanaugh. She’s one of the experts in reproductive sciences who was interviewed for the NPR story.
Still, certain communities in the United States are doing their part to dispel the stigma associated with LARCs, and they’re focusing their efforts on teens and young, college-aged women. One community in Gaston County, N.C. now has nearly 30 percent of its teens and young women using LARCs. Many of the women who have opted to use LARCs claim the ability to plan their families around their career and educational goals offered by LARCs as a motivating factor. Funding from state and federal sources has made it easier for these women’s ambitions to be realized. In Gaston County, federal funding is being used to cover the cost of IUDs for women who are uninsured, and Colorado’s 2016 state budget earmarked 2.5 million dollars to be used towards making LARCs available to low-income women and girls free of cost. South Carolina has also reworked its Medicaid laws to make accessing LARCs easier for women and girls (especially right after they give birth), a move that the federal Department of Health and Human Services has urged other states to emulate. The DHHS has also called on doctors and health care providers to speak with and educate their patients about the benefits of LARCs, while also asking them to make sure they are up-to-speed on the latest information, techniques, and procedures surrounding contraception.
LARCs are not without their opponents, however. Critics point out that the health complications LARCs can cause in users are oftentimes downplayed, which can range from unpredictable bleeding, thin and perforated uterine walls, and headaches to depression and pelvic inflammatory disease (PID). Studies backed by anecdotal evidence suggest that these complications can last for years even after the devices have been removed. Lady Clever contributor Holly Grigg-Spall has written about the link between the push for increased LARC usage and anti-poverty/anti-low-income political rhetoric. Politicians, like publicly-disgraced Republican state senator Russell Pearce, have in the past turned to LARCs and other birth control methods as a means to fight poverty at the expense of implementing long-term solutions like increasing minimum wages and providing affordable education, unfairly placing the onus on women and absolving the government and society of responsibility
While the benefits of LARCs obviously outweigh the drawbacks for these women in Gaston County, N.C., it remains to be seen if the push for LARCs will pay off in the rest of the United States. Visit Southern California Public Radio to read NPR’s full story, and to keep up with any developments on this topic.