Who chooses long-acting reversible contraception (LARC)? patient decision-making around birth control methods in two states

Among U.S. women, use of long-acting, reversible contraception (LARC), including the IUD or implant, is quite low compared to other, less effective birth control methods. While low knowledge about LARC methods may contribute to low uptake, there is little research on what factors my influence patients' decision-making around contraception. To improve knowledge, acceptance, and utilization of LARC, grantees in Colorado and Iowa received dedicated funding to train providers, advertise LARC methods, and provide subsidized devices. Patients receiving reproductive health services at these sites completed surveys regarding their birth control choices, reasons for choosing or not choosing LARC methods, and satisfaction with their clinic visit. Data were analyzed using STATA. Most of the women who completed surveys (n=763) were in their 20s (55%), non-Hispanic white (53%), and U.S. born (82%). Over half (56%) reported leaving the clinic with a hormonal method (pills, patch, ring, or shot), 15% left with an IUD, 9% left with an implant, and 13% left with no method. There were no significant demographic differences among women who chose LARC compared to women who chose other methods. Women who chose LARC methods were significantly more likely to be satisfied with their clinic visit than other women, including having all their questions answered, receiving enough information about birth control methods, and receiving the method that they wanted (OR: 1.64, CI: 1.16-2.31). Results indicate that providing women with more information about birth control methods may improve both patient satisfaction and adoption of LARC methods.