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Long acting reversible contraception

S Haider, C Stoffel, A M Dude
STUDY OBJECTIVE: To describe contraceptive method use by adolescent women in the six months following any pregnancy. DESIGN: We conducted a secondary analysis of the 2011-13 and 2013-15 cycles of the National Survey of Family Growth. SETTING: This survey is a nationally - representative population - based survey of reproductive aged women in the United States. PARTICIPANTS: The sample included respondents who had at least one pregnancy that ended both within the contraceptive calendar period and before the month of the respondent's twentieth birthday...
March 15, 2018: Journal of Pediatric and Adolescent Gynecology
Ashley H Snyder, Carol S Weisman, Guodong Liu, Douglas Leslie, Cynthia H Chuang
OBJECTIVES: The Affordable Care Act (ACA) contraceptive coverage mandate issued in August 2012 requires most private health insurance plans to cover all U.S. Food and Drug Administration-approved contraceptive methods without cost sharing. We evaluate the impact of this policy on out-of-pocket costs and use of long-acting reversible contraceptives (LARCs) and other prescription methods through 2014. METHODS: Data from Truven Health MarketScan were used to examine out-of-pocket costs and contraceptive use patterns for all reversible prescription contraceptives before and after the implementation of the contraceptive mandate for privately insured women ages 13 to 45...
March 2, 2018: Women's Health Issues: Official Publication of the Jacobs Institute of Women's Health
Riina Korjamo, Oskari Heikinheimo, Maarit Mentula
OBJECTIVE: To analyse the post-abortion effect of long-acting reversible contraception (LARC) plans and initiation on the risk of subsequent unwanted pregnancy and abortion. MATERIALS AND METHODS: retrospective cohort study of 666 women who underwent medical abortion between January-May 2013 at Helsinki University Hospital, Finland. Altogether 159 (23.8%) women planning post-abortion use of levonorgestrel-releasing intrauterine system (LNG-IUS) participated in a randomized study and had an opportunity to receive the LNG-IUS free-of-charge from the hospital...
March 14, 2018: European Journal of Contraception & Reproductive Health Care
Ekwutosi M Okoroh, Debra J Kane, Rebekah E Gee, Lyn Kieltyka, Brittni N Frederiksen, Katharyn M Baca, Kristin M Rankin, David A Goodman, Charlan D Kroelinger, Wanda D Barfield
Rates of short interval pregnancies resulting in unintended pregnancies remain high in the United States and contribute to adverse reproductive health outcomes. Long-acting reversible contraception (LARC) methods have annual failure rates of less than 1% compared with 9% for oral contraceptive pills, and are an effective strategy to reduce unintended pregnancies. To increase access to LARCs in the immediate postpartum period, several State Medicaid programs, including those in Iowa (IA) and Louisiana (LA), recently established reimbursement policies to remove the barriers to reimbursement of immediate postpartum LARC insertion...
March 9, 2018: American Journal of Obstetrics and Gynecology
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April 2018: Sexually Transmitted Diseases
Beverly Gray, Serina Floyd, Andra H James
Managing contraception for women at high risk for thrombosis poses unique challenges. Combined estrogen and progestin contraceptives increase the risk of both venous and arterial thrombosis. They are contraindicated in women with a history of thrombosis and in other women at high risk for thrombosis. However, progestin-only contraceptives are generally considered safe in this patient population. This paper reviews the evidence linking hormonal contraception and clotting risk, outlines appropriate contraceptive methods for women at high risk for thrombosis, discusses surgical risk for sterilization in the setting of current or past thrombosis, and includes a review of the safety of hormonal methods for women who are fully anticoagulated...
March 8, 2018: Clinical Obstetrics and Gynecology
Kate Reiss, Suzanne Penfold, Olalere Alabi, Moazzam Ali, Kristen Hopkins, Thoai Dinh Ngo, Kingsley Odogwu, Megan Douthwaite, Onoriode Ezire, Uko Udoh, Effiom Effiom, Erik S Munroe
BACKGROUND: As part of its Family Planning 2020 commitment, the Nigerian government is aiming for a contraceptive prevalence rate of 36% by 2018, and in 2014, approved a policy to allow community health extension workers (CHEWs), in addition to doctors, nurses, and midwives, to provide contraceptive subdermal implants. There is a lack of rigorous evidence on the safety of long-acting reversible contraceptive provision, such as implants, among lower cadres of health providers. OBJECTIVE: This study aimed to compare implant provision by CHEWs versus nurses and midwives up to 14 days post insertion...
March 2, 2018: JMIR Research Protocols
David Hubacher, Hannah Spector, Charles Monteith, Pai-Lien Chen
OBJECTIVES: To measure the 24-month impact on continuation, unintended pregnancy, and satisfaction of trying long-acting reversible contraception (LARC) in a population seeking short-acting reversible contraception (SARC). STUDY DESIGN: We enrolled 916 women aged 18-29 who were seeking pills or injectables in a partially randomized patient preference trial. Women with strong preferences for pills or injectables, started on those products, while others opted for randomization to LARC or SARC and received their methods gratis...
February 19, 2018: Contraception
Frida Gyllenberg, Mikael Juselius, Mika Gissler, Oskari Heikinheimo
OBJECTIVES: To evaluate whether a public program providing long-acting reversible contraceptive (LARC) methods free of charge increases the LARC initiation rate and reduces the unintended pregnancy rate in the general population. METHODS: Since 2013, all women in Vantaa, Finland, have been entitled to 1 LARC method free of charge. With time-series analysis between 2000 and 2015, we assessed whether this public program was associated with changes in steady-state mean rates of LARC initiation and abortions...
February 22, 2018: American Journal of Public Health
Salvatore Caruso, Stefano Cianci, Salvatore Giovanni Vitale, Valentina Fava, Silvia Cutello, Antonio Cianci
PURPOSE: The aim of the study was to investigate the impact of the long-acting reversible contraception (LARC) levonorgestrel-releasing intrauterine system (LNG-IUS 13.5 mg) on sexual function and quality of life (QoL) in women after having undergone abortion for unintended pregnancy. METHODS: In a prospective controlled study, 128 women aged 16-35 years received counseling to adopt LNG-IUS contraception after termination of pregnancy. The Visual Analog Scale (VAS), the Short Form-36 questionnaire (SF-36), the Female Sexual Function Index (FSFI) and the Female Sexual Distress Scale (FSDS) were used to investigate, respectively, pelvic pain levels, QoL, sexual function and sexual distress of these women at baseline (T0) and at 6 (T1) and 12 (T2) months after LNG-IUS placement...
February 13, 2018: European Journal of Contraception & Reproductive Health Care
Nerys Benfield, Felicia Hawkins, Laurie Ray, Andrea McGowan, Ketty Floyd, Dawn Africa, Myrta Barreto, Erika Levi
OBJECTIVES: Nurses play an integral role in intrapartum and postpartum patient education. This exploratory study aims to assess the attitudes, knowledge, and practices of labor and delivery and postpartum nurses regarding contraception, and evaluate for changes in these measures one year after an institutional initiative allowing routine availability of immediate postpartum long-acting reversible contraception (LARC). STUDY DESIGN: In 2014 Montefiore Medical Center began to routinely offer comprehensive immediate postpartum contraception...
February 8, 2018: Contraception
Riley J Steiner, Karen Pazol, Andrea Swartzendruber, Nicole Liddon, Michael R Kramer, Laura M Gaydos, Jessica M Sales
PURPOSE: Long-acting reversible contraceptive (LARC) methods do not require annual clinic visits for continuation, potentially impacting receipt of recommended sexually transmitted infection (STI)/human immunodeficiency virus (HIV) services for young women. We assess service receipt among new and continuing LARC users versus moderately and less effective method users and non-contraceptors. METHODS: Using 2011-2015 National Survey of Family Growth data from sexually active women aged 15-24 years (n = 2,018), we conducted logistic comparisons of chlamydia, any STI and HIV testing, and sexual risk assessment in the past year by current contraceptive type...
February 8, 2018: Journal of Adolescent Health: Official Publication of the Society for Adolescent Medicine
Megan L Evans, Eve Espey, Tony Ogburn, Nikki B Zite
Although long-acting reversible contraception (LARC) use is increasing in the general female population, only 12% of all women who use contraception and 4.8% of nulliparous women in the United States use either the intrauterine device (IUD) or contraceptive implant. In several studies, however, female physicians prefer LARC for contraception. In 2016, an anonymous electronic survey was administered to all U.S. obstetrics and gynecology residents before the start of the annual in-training examination administered by the Council on Resident Education in Obstetrics and Gynecology...
March 2018: Obstetrics and Gynecology
Risa L Fridy, Sofya Maslyanskaya, Sylvia Lim, Susan M Coupey
OBJECTIVE: A 2014 American Academy of Pediatrics (AAP) Policy Statement identified long-acting reversible contraceptives (LARC) as first-line choices for adolescents, but pediatricians' current knowledge and practices about intrauterine devices (IUDs) and subdermal contraceptive implants (Implants) is unknown. We aimed to characterize pediatricians' knowledge and practices about LARCs for adolescents. DESIGN, SETTING, PARTICIPANTS: Cross-sectional online survey emailed to a convenience sample of AAP member pediatricians in New York, Utah, Illinois, and Kansas in 2015 & 2016...
January 31, 2018: Journal of Pediatric and Adolescent Gynecology
Sara Engstrand, Helena Kopp Kallner
OBJECTIVES: The objective of this study was to determine the cost of unintended pregnancy (UP) in Sweden and savings generated by a switch of 5% of women from short acting reversible contraception (SARC) and other methods to long acting reversible contraceptives (LARCs). STUDY DESIGN: We constructed an economic model to estimate the number and costs of UPs and contraceptive use over a 1-year period. The population consisted of all women aged 15-44years requiring reversible contraception and at risk of UP...
February 1, 2018: Contraception
Christophe Vayssière, Adrien Gaudineau, Luisa Attali, Karima Bettahar, Sophie Eyraud, Philippe Faucher, Patrick Fournet, Danielle Hassoun, Marie Hatchuel, Christian Jamin, Brigitte Letombe, Teddy Linet, Marie Msika Razon, Alexandra Ohanessian, Hélène Segain, Solène Vigoureux, Norbert Winer, Sophie Wylomanski, Aubert Agostini
The number of elective abortions has been stable for several decades. Many factors explain women's choice of abortion in cases of unplanned pregnancies. Early initiation of contraceptive use and a choice of contraceptive choices appropriate to the woman's life are associated with lower rates of unplanned pregnancies. Reversible long-acting contraceptives should be favored as first-line methods for adolescents because of their effectiveness (grade C). Ultrasound scan before an elective abortion must be encouraged but should not be obligatory (professional consensus)...
March 2018: European Journal of Obstetrics, Gynecology, and Reproductive Biology
Kristine Hopkins, Celia Hubert, Kate Coleman-Minahan, Amanda Jean Stevenson, Kari White, Daniel Grossman, Joseph E Potter
OBJECTIVE: To identify preferences for and use of short-acting hormonal (e.g., oral contraceptives, injectable contraception) or long-acting reversible contraception (LARC) among community college students in Texas. PARTICIPANTS: Female community college students, ages 18 to 24, at risk of pregnancy, sampled in Fall 2014░or Spring 2015 (N = 966). METHODS: We assessed characteristics associated with preference for and use of short-acting hormonal or LARC methods (i...
February 6, 2018: Journal of American College Health: J of ACH
M Pleaner, C Morroni, J Smit, N Lince-Deroche, M Chersich, S Mullick, D Pillay, M Makua, H Rees
In 2014, South Africa (SA) introduced the subdermal contraceptive implant with the aim of expanding the contraceptive method mix and availability of long-acting reversible methods in the public sector. Three years on, concerns have been raised about the decline in uptake, early implant removals and challenges in service delivery. This article explores the lessons learnt from the introduction of contraceptive technologies elsewhere and applies these to the SA context. Drawing on the World Health Organization’s conceptual framework for the introduction of new contraceptive methods, and subsequent literature on the topic, lessons are classified into six cross-cutting themes...
October 1, 2017: South African Medical Journal, Suid-Afrikaanse Tydskrif Vir Geneeskunde
D Pillay, Matthew Chersich, C Morroni, M Pleaner, O Adeagbo, N Naidoo, S Mullick, H Rees
Background. Implanon NXT, a long-acting reversible contraceptive, was introduced in South Africa (SA) in early 2014, aiming to expand the method mix and increase its effectiveness. Initial uptake was high, but has since declined considerably. In these early years after the implant’s introduction, it is important to identify reasons for the decline, and remedy gaps in services. Objectives. To determine periods of use, reasons for the use and early removal of the implant Implanon NXT. Methods. In 2016, we recruited 152 women from six clinics in the City of Johannesburg, and six in North West Province, SA...
October 1, 2017: South African Medical Journal, Suid-Afrikaanse Tydskrif Vir Geneeskunde
Melinda Vanya, Iván Devosa, Katalin Barabás, György Bártfai, Zoltan Kozinszky
OBJECTIVES: The aims of the study were to describe the sociodemographic determinants, breastfeeding- and sexual life-related predictive factors of contraceptive use at 6-8 weeks postpartum. METHODS: A prospective, web-based questionnaire survey was carried out by distributing an access code to women immediately after delivery at the Department of Obstetrics and Gynaecology, the University of Szeged, Szeged, Hungary, between 1 September 2013 and 1 May 2015. RESULTS: In total, 1875 women were invited to participate in the study, 632 of whom refused or were excluded and 644 were not sexually active...
February 2, 2018: European Journal of Contraception & Reproductive Health Care
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