LARC Project: Uniting Teen Pregnancy Prevention and Infant Mortality Reduction in Baltimore City

Introduction: Baltimore City has high rates of both teen births and infant mortality. To reduce adolescent pregnancies and lengthen interpartum spacing, two major city wide initiatives, Teen Pregnancy Prevention and B'more for Healthy Babies, partnered to develop the Long Acting Reversible Contraceptives (LARCs) Project. Methods: The LARC Project addresses barriers at the policies/system, service delivery, community, and individual levels. At the system level, a coalition of the local/state health departments, non-profit agencies, FQHCs, private medical providers, medical training programs, public schools, and local philanthropies are developing a complete referral network. Service delivery activities include LARC counseling and insertion/removal trainings, a Family Planning Toolkit, and adapting medical education curricula to highlight LARCs. The Know What You Want campaign increases contraceptive knowledge among adolescents /young adults (ages 10-24) who contribute nearly half of all city births. Results: The LARC Project aims to increase availability of LARCs to prevent or delay pregnancy by 2015. Initial efforts focus on strengthening systems though which women obtain LARCs. By the end of year one, we facilitated two citywide strategic planning meetings, actively promoted the expansion of Medicaid family planning coverage, organized LARC insertion/removal trainings, disseminated the Family Planning Toolkit, and launched the Know What You Want campaign. Discussion: Baltimore City is combining pregnancy prevention and infant mortality reduction to reduce teen births and increase birth spacing via LARCs. Strengthening LARC services requires partnerships capable of supporting provider training, communicating knowledge to contraceptive users, and addressing misconceptions of both providers and communities.