Over the past decade, more American women have chosen long-acting reversible contraceptives (LARCs) like intrauterine devices (IUDs) and subdermal hormonal implants for birth control, says a new report from the Centers for Disease Control and Prevention (CDC).
An IUD or coil is a small, usually T-shaped contraceptive device that is inserted into the uterus. Two types are available in the United States: nonhormonal copper IUD (ParaGard) and hormonal IUD (Mirena, Skyla). Failure rates with the copper IUD is about 0.8 percent and 0.2 percent with the hormonal IUD in the first year of use.
A subdermal hormonal implants, or contraceptive implant, is a small flexible tube that is inserted under the skin that prevents pregnancy by releasing hormones that prevent ovaries from releasing eggs and by thickening cervical mucus. Failure rates of hormonal implants are less than 1 percent.
Compared to birth control pills, which have failure rates of approximately 9 percent, long-acting reversible contraceptives are more consistently effective.
Although safety issues during the 1970s resulted in a decline in use of IUDs, both intrauterine devices and subdermal hormonal implants have gained in popularity over the past decade. Use of LARCs waned between 1982 and 1988 and remained stable through 2002, but use has increased nearly five-fold over the last decade.
Use of LARCs among women ages 15 to 44 increased from 1.5 percent in 2002 to 7.2 percent between 2011 and 2013. The highest use between 2011 and 2013 remained highest among women ages 25 to 34 at 11.1 percent compared to ages 15 to 24 at 5 percent and ages 35 to 44 at 5.3 percent.
Women who have previously given birth at least once use LARCs at a higher rate compared to women with no previous births, and the difference increases over time.
LARC use has also diverged by race over the past 30 years. Use tripled among non-Hispanic white women and quadrupled among non-Hispanic black women between 2002 and 2006 to 2010. Use of LARCs decreased by 10 percent among Hispanic women during the same time period.
Despite the increase in use and the effectiveness of LARCs, however, general use remains low in the United States. State leading gynecologists from the American Congress of Obstetricians and Gynecologists (ACOG):
“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.”
Another recent review study found that the birth control shot is associated with an increased risk of HIV.
Contraceptive Impant: http://en.wikipedia.org/wiki/Contraceptive_implant
Intrauterine Devices: http://en.wikipedia.org/wiki/Intrauterine_device
IUDs and hormonal implants have become ‘five times as popular’ over past decade: http://www.medicalnewstoday.com/articles/289874.php
Trends in long-acting reversible contraception use among US women aged 15-44: http://www.cdc.gov/nchs/data/databriefs/db188.htm