K4Health Shines a Spotlight on Long-Acting Reversible Contraception

Long-Acting Reversible Contraceptives

Elizabeth Futrell

(Formerly) CCP | Content Development Lead
IUDs are displayed on a table at the counseling unit in Yusuf Dantsoho memorial hospital in Nigeria’s northern city of Kaduna. © 2012 Akintunde Akinleye/NURHI, Courtesy of Photoshare

IUDs are displayed on a table at the counseling unit in Yusuf Dantsoho memorial hospital in Nigeria’s northern city of Kaduna. © 2012 Akintunde Akinleye/NURHI, Courtesy of Photoshare

Long-acting reversible contraceptives, or LARCs, are getting a lot of attention these days. In 2014, the American Academy of Pediatrics (AAP) released new guidelines recommending that LARCs be the “first line” of contraceptives for preventing adolescent pregnancy in the U.S. In other words, pediatricians should recommend LARCs such as IUDs and implants before shorter-term contraceptive methods such as condoms and pills for teens. Days later, The New England Journal of Medicine published the impressive results of a study showing that providing adolescent girls in the U.S. with information about, and affordable access to, LARCs can reduce rates of unintended pregnancy and abortion by more than 75%.

Then Pathfinder International, Population Services International, Marie Stopes International, and FHI 360 developed a Global Consensus Statement on Expanding Contraceptive Choice for Adolescents and Youth to Include LARCs. Since its launch through the Family Planning 2020 platform, nearly 50 organizations have endorsed the Statement.

LARCs are an exciting option for all women, but they’re especially vital for young women. While adolescent pregnancy is an economic and social challenge in the U.S., it is a matter of life and death in some countries. Globally, pregnancy- and childbirth-related complications are the second leading cause of death of girls ages 15 to 19. Babies of young mothers also face risks: in low- and middle-income countries, babies born to mothers younger than 20 years old have a 50% greater risk of infant mortality than babies born to mothers ages 20 to 29.

LARCs are critical to lowering rates of unwanted pregnancy and related complications like unsafe abortion and maternal and infant morbidity and mortality. While condoms are essential to preventing sexually transmitted infections, they have a typical pregnancy-prevention failure rate of 18%. Oral contraceptive pills and injectable contraception aren’t far behind at 9% and 6%, respectively. In contrast, both IUDs and implants have failure rates of less than 1%.

Over the next few months, K4Health will shine a spotlight on LARCs and explore ways to increase their availability, as well as the impact this access will have on the health of women, girls, and families around the world. Visit our new topic page on LARCs for key messages and the latest essential evidence and tools for provision of LARCs, including the Health Communication Capacity Collaborative’s (HC3’s) new suite of LARC-focused provider counseling tools. Stay tuned for new multimedia resources, an exciting Global Health: Science and Practice supplement, and a thought-provoking thematic blog series featuring expert contributors from diverse organizations and countries.