Current barriers and potential strategies to increase the use of long-acting reversible contraception (LARC) to reduce the rate of unintended pregnancies in Australia: An expert roundtable discussion

Danielle Mazza, Deborah Bateson, Meredith Frearson, Philip Goldstone

Research output: Contribution to journalArticleOtherpeer-review

30 Citations (Scopus)

Abstract

Background: Australia's abortion rates are among the highest in the developed world. Efficacy of the most commonly used form of contraception (oral contraceptives and condoms) relies on regular user compliance. Long-acting reversible contraception (LARC) virtually eradicates contraceptive failure as it is not user-dependent; however, its uptake has been low.Aim: To provide an overview of barriers to LARC use in Australia and potential strategies to overcome these barriers.Method: A roundtable of Australian experts was convened to share clinical perspectives and to explore the barriers and potential strategies to increase LARC use.Results: Three broad barriers to LARC uptake were identified. (i) A paucity of Australian research exists that impedes closure of evidence gaps regarding contraceptive prescription and use. Systematic data collection is required. (ii) Within primary care, lack of familiarity with LARC and misperceptions about its use, lack of access to general practitioners (GPs) trained in LARC insertion/removal and affordability impede LARC uptake. Potential strategies to encourage LARC use include, GP education to promote informed choice by women, training in LARC insertions/removals, effective funding models for nurses to perform LARC insertions/removals, and rapid referral pathways. (iii) At the health system level, primary care incentives to provide LARC to women and health economic analyses to inform government policy changes are required.Conclusions: Although LARC decreases unintended pregnancies by eliminating user compliance issues, its uptake is low in Australia. Strategies that promote LARC uptake by targeting specific barriers may effectively reduce Australia's high unintended pregnancy rate.
Original languageEnglish
Pages (from-to)206-212
Number of pages7
JournalAustralian and New Zealand Journal of Obstetrics and Gynaecology
Volume57
Issue number2
DOIs
Publication statusPublished - 1 Apr 2017

Keywords

  • Australia
  • contraception
  • unwanted pregnancy

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