title: Eliminating health disparities in unintended pregnancy with long-acting reversible contraception (LARC).
abstract: Significant public health disparities exist surrounding teen and unplanned pregnancy in the United States. Women of color and those with lower education and socioeconomic status are at much greater risk of unplanned pregnancy and the resulting adverse outcomes. Unplanned pregnancies reduce educational and career opportunities and may contribute to socioeconomic deprivation and widening income disparities. Long-acting reversible contraception (LARC), including intrauterine devices and implants, offer the opportunity to change the default from drifting into parenthood to planned conception. LARC methods are forgettable; once placed, they offer highly effective, long-term pregnancy prevention. Increasing evidence in the medical literature demonstrates the population benefits of use of these methods. However, barriers to more widespread use of LARC methods persist and include educational, access, and cost barriers. With increasing insurance coverage under the Affordable Care Act and more widespread, no-cost coverage of methods, more and more women are choosing intrauterine devices and the contraceptive implant. Increasing the use of highly effective contraceptive methods may provide one solution to the persistent problem of the health disparities of unplanned and teen pregnancies in the United States and improve women's and children's health.
authors.affiliation: Division of Family Planning, Division of Clinical Research, Department of Obstetrics and Gynecology, Washington University, School of Medicine, St Louis, MO; Department of Obstetrics and Gynecology, Indiana University, Indianapolis, IN.
authors.forename: Caitlin
authors.initials: C
authors.lastname: Parks
authors.affiliation: Division of Family Planning, Division of Clinical Research, Department of Obstetrics and Gynecology, Washington University, School of Medicine, St Louis, MO; Department of Obstetrics and Gynecology, Indiana University, Indianapolis, IN. Electronic address: jpeipert@iu.edu.
authors.forename: Jeffrey F
authors.initials: JF
authors.lastname: Peipert
mesh_terms: D000293:Adolescent; D003271:Contraceptive Agents, Female / Q000627:therapeutic use*; D003274:Contraceptive Devices, Female; D003692:Delayed-Action Preparations / Q000627:therapeutic use*; D005260:Female; D006297:Health Services Accessibility; D006801:Humans; D019458:Insurance Coverage; D010342:Patient Acceptance of Health Care; D010349:Patient Compliance; D011247:Pregnancy; D011253:Pregnancy in Adolescence / Q000517:prevention & control; D049168:Pregnancy, Unplanned; D014481:United States
chemical_list: D003271:Contraceptive Agents, Female; D003692:Delayed-Action Preparations
keywords: implants; intrauterine devices; long-acting reversible contraception; unplanned pregnancy; women’s health