In 2011, the unintended pregnancy rate decreased from 51% in 2008 to 45%. Of women using contraception, 7.2% were using a LARC in 2011-2013 as compared to 1.5% in 2002. Increasing LARC use decreases unintended pregnancies, however, data are lacking regarding barriers to the uptake of this contraception. The purpose of this study was to identify the barriers to adoption of LARC in a young adult population in Florida.
This project is a computer-based survey of females aged 18 to 30 at our institution’s satellite clinics. Survey questions address age, race, education level, insurance, income, obstetric and sexual history, and contraceptive use, knowledge about efficacy, safety, and misperceptions of intrauterine contraception.
We found that 5.3% of the participants use an IUD and 57.9% use no method of contraception. One third of patients answered correctly about the failure rate of “typical use” of a LARC, and 40% of patients answered correctly the failure rate in “perfect use” of a LARC. About half of patients believed the IUD increases risk of pelvic inflammatory disease, and 40.9% believed that it causes infertility. Moreover, we found that patients are most influenced by their gynecologist regarding contraceptive options.
Based on these findings, education is likely the main barrier to uptake of a LARC method. Gynecologists play a key role in providing contraceptive counseling and education to our patients, and should make this education part of every visit with our patients to provide them the most comprehensive care possible.