The benefits of Long-Acting Reversible Contraception

Issue

Long-acting reversible contraception (LARC) such as IUDs or implants, is highly effective, safe, and associated with lower abortion rates. However, access to LARC is challenging during COVID-19 as health providers increasingly turn to telemedicine visits, supply chains are disrupted, and patients are reluctant or unable to go to offices or clinics.

Postpartum Family Planning (PPFP) and Post-abortion care during COVID-19 offer an ideal opportunity (and sometimes the only option) for women to access contraception, particularly LARC, while minimising the burden on healthcare systems; as once inserted, they can remain for many years without the need for follow-up.

What others are doing

Across the world, physicians and governments are working to maintain women's access to contraception, including LARC.

The Obstetrical and Gynaecological society of Bangladesh's PPIUD initiative team drafted a series of recommendations on the continuation of contraceptive service provision, which has since been adopted by the Directorate General of Family Planning.
At Oxford University Hospital NHS Trust in the UK, immediate postpartum family services were implemented in April 2020. The pandemic resulted in decentralisation of decision-making, allowing for rapid implementation of this essential service.
FIGO, as well as other professional societies and health bodies are informing membership that removal and exchanges of implants and IUDs can be deferred temporarily, depending on the device.

What you can do

Capitalise on the opportunity to provide PPFP during maternity services – antenatal counselling and immediate pospartum provision.
Check research on effectiveness of IUDs and implants beyond their expiration date, and removal of IUDs and implants should be postponed where possible.
Use telehealth visits to screen and provide patient -centred counselling.
If LARC is not possible, encourage use of self-administered contraception as a bridge to later initiation of LARC.