|Dr. Enrique Jacome
A new Centers for Disease Control and Prevention report finds a shift in preferences for birth control among American women, who are increasingly opting for long-lasting reversible contraceptives.
Long-acting reversible contraceptives (LARCs) include intrauterine devices (IUDs) and subdermal hormonal implants. Although IUDs were used more commonly in the US during the 1970s, concerns over their safety prompted a decline in use of these devices.
Since then, however, IUDs have been redesigned with safety in mind, and the Centers for Disease Control and Prevention (CDC) report shows that there has been growing interest in IUDs and 5-year contraceptive implants – which were approved in 1990 – because these contraceptive methods are highly effective at preventing unintended pregnancies.
IUDs are placed inside the uterus, where they release hormones or copper to prevent pregnancies. The CDC say that the failure rate for IUDs is below 1%, making them more effective than the birth control pill, which – partly due to users sometimes forgetting to take the pill – has a failure rate of about 9%.
According to the CDC’s National Center for Health Statistics (NCHS) data, the use of LARCs waned during 1982-88 and remained stable up until 2002, but it has increased nearly five-fold over the last decade.
Among women aged 15-44, use of LARCs has increased from 1.5% in 2002 to 7.2% during 2011-13. The data also show LARCs are most popular among women aged 25-34 – more than twice as many women in this age group used LARCs during 2011-13 as women in other age groups.
Women who have given birth at least once were also found to be more likely to use LARCs compared with women who have not previously given birth. The report also found that this difference has increased over time.
CDC report tracks divergence in LARC use by race
There has also been a divergence in LARC use by race over the past 30 years. LARC use tripled among non-Hispanic white women between 2002 and 2006-10 and quadrupled among non-Hispanic black women, but LARC use among Hispanic women declined by 10% during this period.
Between 2006-10 and 2011-13, LARC use increased by 30% among non-Hispanic black women, however, there was a much higher increase in use among Hispanic (129%) and non-Hispanic white (128%) women. According to the report, non-Hispanic white women have traditionally used LARCs at the lowest rate.
When informed about the range of contraceptive options available to them, women are more likely to opt for long-acting contraceptive methods over the oral contraceptive pill or transdermal patch, recent research has found.
Despite this, the birth control pill remains the most popular contraceptive, used by 16% of women in the US.
Leading gynecologists from the American Congress of Obstetricians and Gynecologists (ACOG) say that while women are increasingly taking up LARCs as contraceptive options, use is still relatively low in the US:
“In part, high unintended pregnancy rates in the US may be the result of relatively low use of long-acting reversible contraceptive methods, specifically the contraceptive implant and intrauterine devices.”