Changes in use of long-acting contraceptive methods in the U.S., 2007-2009

Long-acting reversible contraceptive methods such as the IUD and implant are among the most efficacious and cost-effective methods available. Despite an increase in LARC use from 2.4% of all method use in 2002 to 5.6% in 2006-08, LARC use in the U.S. remains low compared to less-effective methods. However, recent data indicate that that American women may be responding to increased clinical focus on these methods. Here, we analyze new nationally representative data from the 2006-10 National Survey of Family Growth. We examine bivariate associations between sociodemographic characteristics and LARC use, and examine significant changes in use between the two survey periods of 2006-08 and 2008-10.

The proportion of contraceptors using LARC increased significantly and substantially through 2008-10 (to 8.5%); the increase was seen among women of all ages, races, parities, marital and educational statuses, incomes, and religions. Among those 15-19, use of LARC tripled from 1.5% to 4.5%, an increase almost wholly attributable to older teens 18-19. LARC use among women 20-24 nearly doubled, from 4.2% to 8.3%. Additional analyses will examine the role of sterilization vis-à-vis LARC.

In the context of high unintended pregnancy rates, these increases are promising, especially for women 18-24. The lengthening period between age at first sex and age of first birth highlights the need for longer-acting methods that will reduce exposure to risk of unintended pregnancy and associated morbidities. Findings from this analysis may help to identify groups of women that could benefit from increased efforts to promote the IUD and implant.