According to a report released on February 24 by the Centers for Disease Control and Prevention (CDC), long-acting, reversible contraceptives (LARCs), specifically, intrauterine devices (IUDs) and implants, are increasing in popularity among US women. During the 1980s and 1990s, the popularity of LARCs declined; however, the new CDC report notes that their use has soared five-fold in the last decade among women aged 15–44, increasing from 1.5% in 2002 to 7.2% in 2011–2013. For the report, the CDC accessed data from the 1982, 1988, 1995, 2002, 2006–2010, and 2011–2013 National Survey of Family Growth (NSFG).
The report, entitled Trends in Long-acting Reversible Contraception Use Among U.S. Women Aged 15–44, notes that in 1982 and since 2002, women aged 25–34 used LARC contraception at a higher rate compared with women aged 15–24 or 33–44. In addition, patterns of use of LARC varied by race and Hispanic origin over the last 30 years, and women who have had at least one birth use LARC methods at a higher rate than women who have had no previous births.
The percentage of women using LARCs has remained highest among women aged 25–34, with more than twice as many women aged 25–34 (11.1%) using LARCs in 2011–2013 compared with women aged 15–24 (5.0%) and aged 35–44 (5.3%). The report notes that LARCs are gaining popularity due to their high rate of effectiveness in preventing unintended pregnancies. In the 1970s, IUD use was more common among US women in the 1970s; however, safety concerns resulted in a subsequent decline. Then, following approval of a five-year contraceptive implant in 1990 and redesigned IUDs, there has been increasing interest in the use of LARCs for unintended pregnancy prevention. According to the CDC, in 2006 (the most recent data available) 49% of pregnancies in the US were unintended, meaning mistimed, unplanned, or unwanted at the time of conception. Among women aged 19 years and younger, more than four out of five pregnancies were unintended.
Since 2002, IUDs have accounted for the largest proportion of LARC usage. Comparing 2006–2010 with 2011–2013, IUD use soared 83% (from 3.5% to 6.4%); in addition, implant use tripled (from 0.3% to 0.8%). Studies have found that, aside from abstinence, LARCs are the most effective forms of birth control. According to the CDC, hormonal implants, a small rod implanted in the arm, as well as the IUD, a small device that is inserted into the uterus, both result in less than one pregnancy per 100 women annually. Implants have a 0.05% failure rate, hormonal IUDs have a 0.2% failure rate, and copper IUDs have a 0.08% failure rate. The male condom has an 18% failure rate, and the birth control pill has a 9% failure rate. Incorrect usage of a condom or forgetting pills contribute to their failure rates.