Examining Reasons for Intent to Discontinue and Remove LARCs: National Survey of Family Growth 2017-2019

Background Long-acting reversible contraception (LARC) are highly-effective forms of contraception, which can reduce the risk of unintended pregnancy. Despite LARCs effectiveness, women may desire to discontinue this method. This study will examine reasons for intent to discontinue and remove LARCs among US women aged 15-49 from 2017-2019. Methods The National Survey of Family Growth2017-2019 was utilized with a sample of 6141 female respondents. Descriptive statistics for intention to discontinue LARCs, difficulty removing LARCs, and reasons for LARC discontinuation and removal were examined. Rao-Scott chi-square tests were conducted in SAS. Results Overall, 22.9% of women reported ever using LARCs. Among LARC users, most women (81.2%) reported using LARC in the past 10-years. Among these women, 63.9% intended to discontinue LARCs, and 11.5% had difficulty removing LARCs. Reasons for wanting to discontinue LARCs include decided to get pregnant (15.9%), side effects (29.6%), LARC complications (19.3%), and LARC expiration (26.8%). Primary reasons reported for difficulty removing LARCs included: complications (68.3%), discouragement by provider (6.8%), provider's inability to remove (4.9%), removal not covered by insurance (3.8%), and could not get removed (3.7%). Conclusion Given that women who use a LARC method rely on providers to remove this contraceptive method, understanding the reasons for discontinuation and difficulties encountered are needed. Findings from this nationally representative sample identified provider-level and system-level barriers for LARC removal. In order to respect the reproductive autonomy of LARC users method for pregnancy prevention, these barriers must be overcome.