Long-Term Birth Control Use Soars For American Women

The once little-used contraceptive method is making a big comeback.
After nearly disappearing from the market 30 years ago, the once rarely used long-acting reversible contraceptive is now the fastest-growing birth control method among American women.
Between 2011 and 2013, 11.6 percent of women opted for LARC methods like implants and intrauterine devices (IUDs), up from 6 percent between 2006 and 2010, according to a report released Tuesday by the National Center for Health Statistics.
While use of the most common methods of contraception like the pill, sterilization or the male condom held steady, LARC methods represent a small but rapidly growing share of the contraceptive choices for women. Experts note that the growth is largely driven by IUDs, while implants make up a small share of the LARC options.

The pill is still the most popular contraceptive method, followed closely by female sterilization: More than a quarter of women aged 15 to 44 use the pill (25.9 percent), while another quarter (25.1 percent) go the route of sterilization.

Centers For Disease Control And Prevention/National Center For Health Statistics

Megan Kavanaugh, senior research scientist for the sexual and reproductive health-focused Guttmacher Institute, points to several factors contributing to the rise in LARC popularity: Health care providers get more and better training on the devices, medical groups have voiced growing preference for LARCs and consumer marketing has raised awareness of the option.

"A lot of that is trickling down to the patient side," Kavanaugh said. "Patients, particularly younger patients, are learning about [LARCs] as an option. As more women use these methods, they're likely to share their experience with their friends, so it grows by word of mouth."

The current popularity of LARC methods stands in sharp contrast to the 1980s and 1990s, when use dwindled after the Dalkon Shield scandal of the 1970s. The intrauterine contraceptive device was yanked from the market after an estimated 200,000 women were injured, many became infertile and about 20 died from infections related to the IUD.

Kavanaugh notes that the U.S. is unique in high usage of oral contraceptives and sterilization; LARC use is much higher in other developed countries.

"We think that's in relation to the Dalkon Shield," Kavanaugh said. "It kind of tainted the entire [U.S.] industry."

With safer options on the market, LARC methods are getting the support of groups like the American College of Obstetricians and Gynecologists, which earlier this year strengthened its recommendations regarding the use of LARC methods and called them "the most effective and safe forms of non-permanent contraception."

According to the NCHS, contraceptive methods like the pill and injections vary widely across race and education level. Women with a college education overwhelmingly opt for the pill, while injectable contraception is most common among women with the lowest levels of education. While condom use was about equal across racial lines, non-Hispanic black women had the highest rates of using female sterilization as a contraceptive method.

Use of LARC methods increased "almost uniformly" across the total population of users, according to Kavanaugh's recent study for the Guttmacher Institute.

In the coming years, Kavanaugh said she expects LARC use will increase even more following the rollout of the Affordable Care Act, which requires most insurance plans to cover all types of birth control at no cost.

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