Same-day LARC insertion attitudes and practices

Abstract

Background: Little is known regarding clinicians' attitudes about or the extent to which the recommendation to offer same-day insertions for long-acting reversible contraception (LARC) is applied in practice.

Study design: Since 2006, 47 family planning agencies in Colorado and Iowa participated in two initiatives to reduce unintended pregnancy by increasing LARC provision. Clinic directors (n = 45) and clinicians (n = 114) participating in these initiatives were interviewed and surveyed regarding their LARC provision practices and attitudes.

Results: Agencies required fewer visits for the contraceptive implant than for the intrauterine device (IUD). Only 18% of agencies typically offered an IUD, and 36% typically offered an implant in one visit. Years of experience and professional title significantly predicted attitudes about the number of visits required to get LARC.

Discussion: Barriers must be overcome for full implementation of professional LARC guidelines and for more women to receive chosen methods without the extra burden of multiple visits.

Keywords: Barriers to care; Colorado; Family planning; Iowa; Long-acting reversible contraception; Low income; Professional guidelines; Women.