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Long-Acting Reversible Contraception

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21. Long-acting reversible contraception: levonorgestrel 13.5 mg intrauterine delivery system

Long-acting reversible contraception: levonorgestrel 13.5 mg intrauterine delivery system L Long-acting re ong-acting rev versible contr ersible contraception: aception: le lev vonorgestrel 13.5 onorgestrel 13.5 mg intr mg intrauterine deliv auterine delivery ery system system Evidence summary Published: 4 June 2014 nice.org.uk/guidance/esnm41 pathways K Ke ey points from the e y points from the evidence vidence The content of this evidence summary was up-to-date in June 2014. See summaries (...) in Nelson et al. (2013) (n=1432): 10 pregnancies occurred over 3 years (0.33 pregnancies per 100 woman-years). The contraceptive failure rate was 0.4% in year 1 and 0.9% over 3 years, which is similar to failure rates seen with correct and consistent use of other methods of long- acting reversible contraception. Safety Safety In women using the levonorgestrel 13.5 mg intrauterine system in the study: 8 serious adverse events were reported (0.6%) including 3 ectopic pregnancies and 2 cases of pelvic

2014 National Institute for Health and Clinical Excellence - Advice

22. Hormonal Contraceptives

- if no, emphasize benefits of Long-Acting Reversible Contraception (LARC) i.e., IUDs, injectable medroxyprogesterone Hormonal contraceptives can be safely provided to most healthy women after a careful medical history and blood pressure measurement. Before prescribing: Assess the patient’s medical history Cardiovascular risk factors: Smoker Obesity (BMI >30kg/m 2 ) History of MI, stroke or VTE Hypertension (controlled?) Dyslipidemia Diabetes (controlled?) Migraine (with or without aura?) Breast cancer history (...) are not associated with an increased risk of thromboembolism. 1) Non-prescription contraceptive options Failure rates with typical use over a year Male condoms (11-16%) Diaphragm (15%) Sponge (16-30%) Female condoms (20%) Spermicide alone (30%) Condoms provide protection against STIs 2) Prescription options Patients should be counselled about the advantages and disadvantages of long-acting reversible contraceptives (copper IUD, levonorgestrel-eluting IUDs, depo-medroxyprogresterone injection). If a long-acting

2018 medSask

23. What does the evidence say about the delivery and receipt of post-natal contraception in healthcare settings?

. National Institute for Health and Care Excellence. Long-acting reversible contraception : guidance (CG30). NICE; 2005. 3. McKeating A, Crosby DA, Collins M, O'Higgins A, McMahon L, Turner MJ. A longitudinal study of unplanned pregnancy in a maternity hospital setting. International Journal of Gynaecology & Obstetrics. 2015;128(2):106-9. 4. World Health Organization. Programming strategies for postpartum family planning. Geneva, Department of Reproductive Health and Research; 2013. 5. Royal College (...) . Views of general practitioners on providing contraceptive advice and long-acting reversible contraception at the 6-week postnatal visit: a qualitative study. Journal of Family Planning & Reproductive Health Care. 2016;42(2):99-106. 9. Falk G, Ostlund I, Magnuson A, Schollin J, Nilsson K. Teenage mothers - a high-risk group for new unintended pregnancies. Contraception. 2006;74(6):471-5. 10. Doherty E, Smith A. Postnatal contraception planning for young women. MIDIRS Midwifery Digest. 2006;16(2):237

2017 Public Health England - Evidence Briefings

24. What do current policies and guidance say about the provision of post-natal contraception to women in healthcare settings?

for Health and Care Excellence. Antenatal and postnatal mental health: clinical management and service guidance : guidance (CG192). NICE; 2014. 9. National Institute for Health and Care Excellence. Long-acting reversible contraception : guidance (CG30). NICE; 2005. 10. National Institute for Health and Care Excellence. Postnatal care [Pathway]. NICE; [Available from: http://pathways.nice.org.uk/pathways/postnatal-care. 11. National Institute for Health and Care Excellence. Postnatal care. Quality (...) and guidance on family planning and the provision of postnatal contraception to women in healthcare settings. Key messages ? Postnatal contraception is an important determinant of child an maternal health outcomes ? Take every opportunity to provide advice on postnatal contraception ? All providers should have accurate and up-to-date knowledge about the various postnatal contraceptive options ? Listen to women’s views about contraceptive methods and support them to make informed choices ? Contraception

2017 Public Health England - Evidence Briefings

25. Contraception after surgical abortion

into abortion care and that many are able to provide women with short-acting reversible contraception [85]. However, there are signi?cant barriers to provision of IUDs and implants at many clinics (GRADE 1B)[86,87].In asurveyofNationalAbortion Federation memberfa- cilities, 36% provide immediate postabortion IUDs and 17% provide postprocedureimplants,with thehighestrates notedin states with contraceptive coverage mandates or Medicaid family planning 5 A.H.Roe,D. Bartz/Contraception99(2019)2–9expansion (...) C, Hagbom-Ma C, et al. Impact of a theory-based video on initiation of long-acting reversible contraception after abortion. Am J Obstet Gynecol 2015;212(3):310.31–7 [EvidenceGrade: I]. [27] StewartH,McCallSJ,McPhersonC,TowersLC,LloydB,FletcherJ,etal.Effectiveness of peri-abortion counselling in preventing subsequent unplanned pregnancy: a systematic review of randomised controlled trials. J Fam Plann Reprod Health Care2016;42(1):59–67. [28] Matulich M, Cansino C, Culwell KR, Creinin MD

2018 Society of Family Planning

26. Using the theory of planned behavior and self-identity to explore women's decision-making and intention to switch from combined oral contraceptive pill (COC) to long-acting reversible contraceptive (LARC). Full Text available with Trip Pro

Using the theory of planned behavior and self-identity to explore women's decision-making and intention to switch from combined oral contraceptive pill (COC) to long-acting reversible contraceptive (LARC). \Most college women use the combined oral contraceptive pill (COC) despite more effective long-acting reversible contraceptive (LARC) methods (e.g., IUDs and implant) being available. Resistance to change methods may be impacted by how a woman identifies with being a COC-user.Data were

2019 BMC Women's Health

27. Shared Negative Experiences of Long-Acting Reversible Contraception and their Influence on Contraceptive Decision-Making: A Multi-Methods Study. (Abstract)

Shared Negative Experiences of Long-Acting Reversible Contraception and their Influence on Contraceptive Decision-Making: A Multi-Methods Study. We explored how negative stories about long-acting reversible contraception (LARC) - defined as a firsthand negative experience with LARC shared directly with the study participant - were involved in participants' decisions about whether to use LARC following abortion, and how counseling affected the influence of negative LARC stories on contraceptive (...) were valued informants; (3) potential side effects were important to LARC decision-making; and (4) positive and negative features of the counseling encounter influenced the effect of negative LARC stories.Negative LARC stories are common among women presenting for abortion at our institution and may influence patient uptake of these methods. Implications This study uses a multi-methods approach to examine the influence of negative stories about long-acting reversible contraception (LARC

2019 Contraception

28. The Zika Contraception Access Network: a feasibility programme to increase access to contraception in Puerto Rico during the 2016–17 Zika virus outbreak Full Text available with Trip Pro

for the Centers for Disease Control and Prevention (CDCF) secured a supply of reversible contraceptive methods (including long-acting reversible contraception), made available to non-sterilised women of reproductive age at no cost through provider reimbursements and infrastructure supported by the CDCF. To build capacity in contraception service provision, doctors and clinic staff from all public health regions and nearly all municipalities in Puerto Rico were recruited into the programme. All providers (...) completed 1 day of comprehensive training in contraception knowledge, counselling, and initiation and management, including the insertion and removal of long-acting reversible contraceptives (LARCs). Z-CAN was announced through health-care providers, word of mouth, and a health education campaign. Descriptive characteristics of programme providers and participants were recorded, and we estimated the factors associated with choosing and receiving a LARC method. As part of a Z-CAN programme monitoring

2018 The Lancet. Public health

29. Long acting reversible contraception use and associated factors among married women of reproductive age in Nepal. Full Text available with Trip Pro

Long acting reversible contraception use and associated factors among married women of reproductive age in Nepal. Modern contraceptives are highly effective and proven means of preventing unintended pregnancy and reducing maternal mortality. Social and economic characteristics are some of the key determinants of health and utilization family planning. However, studies examining the factors associated with utilization of long acting reversible contraception (LARC) are limited in Nepal

2019 PLoS ONE

30. Trends, patterns and determinants of long-acting reversible methods of contraception among women in sub-Saharan Africa. Full Text available with Trip Pro

Trends, patterns and determinants of long-acting reversible methods of contraception among women in sub-Saharan Africa. Method-specific contraceptive prevalence varies widely globally, as huge variations exist in the use of different types of contraception, with short-term methods being the most common methods in sub-Saharan Africa (SSA). Evidence is scanty on the trends, patterns and determinants of long-acting reversible contraceptive (LARC) methods in SSA. This study aimed to address (...) this knowledge gap.Using a pseudo longitudinal research design and descriptive and inferential statistics, we analysed Demographic and Health Survey data of eight countries selected on the basis of contraceptive prevalence rates across SSA. Multinomial logistic regression modelling was used to tease out the predictors of the uptake of LARC methods in the selected countries.Findings exhibit a steady but slow upward trend in LARC methods across selected countries, as a marginal increase was recorded in LARC

2019 PLoS ONE

31. Contextual influences on the choice of long-acting reversible and permanent contraception in Ethiopia: A multilevel analysis. Full Text available with Trip Pro

LARP methods was significantly lower among adolescents (OR, 0.53; 95% CI, 0.32-0.85) and women over the age of 40 (OR, 0.63; 95% CI, 0.44-0.90) compared to women in their 20's.The findings of this study indicate that the demand for long-acting reversible and permanent contraception is influenced not only by women's individual and household characteristics but also by the community's level of women's empowerment, socio-economic development, as well as access and exposure to family planning (...) Contextual influences on the choice of long-acting reversible and permanent contraception in Ethiopia: A multilevel analysis. Long acting reversible and permanent contraception (LARPs) offer promising opportunities for addressing the high and growing unmet need for modern contraception and helps to reduce unintended pregnancies and abortion rates in sub-Saharan Africa (SSA). This study examines the contextual factors that influence the use of long acting reversible and permanent contraception

2019 PLoS ONE

32. Religious refusals to long-acting reversible contraceptives in Catholic settings: a call for evidence. Full Text available with Trip Pro

Religious refusals to long-acting reversible contraceptives in Catholic settings: a call for evidence. No-cost contraceptive provisions as in the Affordable Care Act have substantially reduced the financial burdens that patients previously faced with long-acting reversible contraception (LARC) access. Such efforts have contributed to improved LARC uptake and substantial declines in unintended pregnancy and abortion rates. However, governmental protections that allow religious restrictions

2020 American Journal of Obstetrics and Gynecology

33. Motivational interviewing to promote long-acting reversible contraception among Rwandan couples wishing to prevent or delay pregnancy. Full Text available with Trip Pro

Motivational interviewing to promote long-acting reversible contraception among Rwandan couples wishing to prevent or delay pregnancy. Few family-planning programs in Africa base demand creation and service delivery on theoretical models. Motivational interviewing is a counseling modality that facilitates reflection on the benefits and disadvantages of a health outcome to encourage behavior change.We evaluate a couples-focused joint family-planning and HIV counseling intervention using (...) testing and family-planning counseling. At the first follow-up visit 1 month after enrollment in the parent study, couples who had not yet chosen a long-acting reversible contraception method were interviewed separately using motivational interviewing and then brought together and again offered long-acting reversible contraception.Following motivational interviewing, 78 of 229 couples (34%) requested a long-acting reversible contraception method (68 implant and 10 intrauterine device). Long-acting

2020 American Journal of Obstetrics and Gynecology

34. Statewide quality improvement initiative to implement immediate postpartum long-acting reversible contraception. Full Text available with Trip Pro

Statewide quality improvement initiative to implement immediate postpartum long-acting reversible contraception. Women face barriers to obtaining contraception and postpartum care. In a review of Tennessee birth data from 2014, 56% of pregnancies were unintended, 22.7% were short-interval pregnancies, and 57.9% of women who were not intending to get pregnant were not using contraception. Offering long-acting reversible contraceptive methods in the immediate postpartum period allows women who (...) desire these effective methods of contraception to obtain unobstructed access and lower unintended and short-interval pregnancy rates.We report the experience of Tennessee's perinatal quality collaborative that aimed to address unintended and short-interval pregnancy by increasing access to immediate postpartum long-acting reversible contraception through woman-centered counseling and ensuring reimbursement for devices. This followed a policy change in November 2017 that allowed women who were

2020 American Journal of Obstetrics and Gynecology

35. Stage-based implementation of immediate postpartum long-acting reversible contraception using a reproductive justice framework. Full Text available with Trip Pro

Stage-based implementation of immediate postpartum long-acting reversible contraception using a reproductive justice framework. The immediate postpartum period is a favorable, safe, and effective time to provide long-acting reversible contraceptives, yet it is not available widely. We describe an innovative hospital-based approach to immediate postpartum long-acting reversible contraceptives that includes (1) an emphasis on multidisciplinary teambuilding and identification of champions, (2 (...) ) a focus on the use of implementation science at every stage of the process to develop a systematic and replicable strategy, and (3) an imperative to apply a reproductive justice framework to immediate postpartum long-acting reversible contraceptive implementation. Our model was developed with the use of implementation science best practices. Implementation teams comprised of diverse stakeholders were formed and included champions to promote progress. Our team assessed the implementation context

2020 American Journal of Obstetrics and Gynecology

36. Patient perceptions of immediate postpartum long-acting reversible contraception: A qualitative study. Full Text available with Trip Pro

Patient perceptions of immediate postpartum long-acting reversible contraception: A qualitative study. The objective of this study was to explore perceptions and experiences of immediate postpartum long-acting reversible contraception (LARC) counseling and decision-making, with a focus on reproductive autonomy. We aimed to assess the potential for reproductive coercion.This was a qualitative study using semi-structured interviews with Spanish and English speaking women who received (...) an intrauterine device or contraceptive subdermal implant immediately postpartum. They were recruited before discharge from two hospitals in Baltimore, MD. We analyzed interviews using directed content analysis.We interviewed a diverse group of 17 women. Participants praised the convenience of LARC and the ease of immediate postpartum placement. Some women reported feeling pushed by providers during counseling and were critical of their experiences. Women expressed a desire for comprehensive, objective

2020 Contraception

37. Long-Acting Reversible Contraception Free-of-Charge: Two-year Discontinuation, its Risk Factors and Reasons. (Abstract)

Long-Acting Reversible Contraception Free-of-Charge: Two-year Discontinuation, its Risk Factors and Reasons. Since 2013, the residents of the city of Vantaa, Finland, have been offered their first long-acting reversible contraceptive method (levonorgestrel-releasing intrauterine system, implant, and copper intrauterine device) free-of-charge.The primary aim was to assess the two-year cumulative discontinuation rates of long-acting reversible contraceptive methods when provided free-of-charge (...) for first-time users in a real-world setting. Additional aims were to describe factors associated with discontinuation, and to evaluate the reasons for discontinuation.This is a retrospective register-based cohort study of all 2026 non-sterilized women aged 15-44 years, who initiated a long-acting contraceptive method free-of-charge in 2013-2014 in the city of Vantaa. Removals within two years after method initiation and reasons for discontinuation were obtained from electronic health records and from

2020 American Journal of Obstetrics and Gynecology

38. An initiative to implement immediate postpartum long-acting reversible contraception in rural New Mexico. Full Text available with Trip Pro

An initiative to implement immediate postpartum long-acting reversible contraception in rural New Mexico. Over the past decade, many states have developed approaches to reimburse for immediate postpartum long-acting reversible contraception. Despite expanded coverage, few hospitals offer immediate postpartum long-acting reversible contraception.Immediate postpartum long-acting reversible contraception implementation is complex and requires a committed multidisciplinary team. After New Mexico (...) Medicaid approved reimbursement for this service, the New Mexico Perinatal Collaborative developed and initiated an evidence-based implementation program containing several components. We sought to evaluate timing of the implementation process and facilitators and barriers to immediate postpartum long-acting reversible contraception in several New Mexico rural hospitals. The primary study outcome was time from New Mexico Perinatal Collaborative program component introduction in each hospital

2020 American Journal of Obstetrics and Gynecology

39. Impact of the Rochester LARC Initiative on adolescents' utilization of long-acting reversible contraception. Full Text available with Trip Pro

Impact of the Rochester LARC Initiative on adolescents' utilization of long-acting reversible contraception. Preventing unintended teen pregnancy is a national public health priority, and increasing access to long-acting reversible contraception is part of the recommended strategy for the achievement of this goal. Nevertheless, adolescent long-acting reversible contraceptive use across the nation has remained low, even after national and state-level programs increased coverage for no-cost (...) contraception. One persistent barrier is misinformation about the safety, efficacy, and availability of long-acting reversible contraception for teens. To overcome this barrier, the Hoekelman Center, in collaboration with multiple partners, designed and implemented a community health intervention. The Greater Rochester LARC Initiative disseminated accurate information about contraceptive options with a focus on long-acting reversible methods by delivering interactive lunch-and-learn talks throughout

2020 American Journal of Obstetrics and Gynecology

40. Fertility intentions and long-acting reversible contraceptive use among HIV-negative single mothers in Zambia. Full Text available with Trip Pro

Fertility intentions and long-acting reversible contraceptive use among HIV-negative single mothers in Zambia. Integrating family planning interventions with HIV studies in developing countries has been shown to prevent mother-to-child HIV transmission and simultaneously reduce HIV and unintended pregnancy in high-risk populations. As part of a prospective cohort study on HIV incidence and risk factors in Zambian women having unprotected sex, we also offered family planning counseling (...) at baseline were more likely to discontinue earlier (P=.016).This study demonstrates that integrated family planning services can increase long-acting reversible contraceptive use successfully among Zambian single mothers, who are a vulnerable population that disproportionately is affected by unintended pregnancy. A steady increase in use over time confirms the importance of repeated messaging about these unfamiliar methods. Thus, it is imperative that family planning interventions target single mothers

2020 American Journal of Obstetrics and Gynecology

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