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Strategies to prevent unintended pregnancy: increasing use of long-acting reversible contraception.
MedLine Citation:
PMID:  20634208     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
BACKGROUND Despite increasing contraceptive availability, unintended pregnancy remains a global problem, representing as many as 30% of all known pregnancies. Various strategies have been proposed to reverse this disturbing trend, especially increased use of long-acting reversible contraceptive (LARC) methods. In this review we aim to discuss the role of LARC methods and importance of contraceptive counseling in reducing unintended pregnancy rates. METHODS References/resources cited were identified based on searches of medical literature (MEDLINE, 1990-2009), bibliographies of relevant publications and the Internet. RESULTS AND CONCLUSIONS LARC methods-copper intrauterine devices (IUDs), progestogen-releasing intrauterine system and injectable and implantable contraceptives-are safe and effective contraceptive options (unintended pregnancy rates with typical versus perfect use: 0.05-3.0 versus 0.05-0.6%) that are appropriate for a wide range of women seeking to limit or space childbearing. Despite their safety and efficacy records, these methods remain underutilized; injectable and implantable methods are used by an estimated 3.4% and intrauterine methods by 15.5% of women worldwide. LARC methods require no daily or coital adherence and avoid the adverse events and health risks of estrogen-containing contraceptives. The copper IUD and progestin-only injections and implants have been shown to be more cost-effective than more commonly used methods, such as condoms and the pill (5-year savings: $13 373-$14 122, LARC; $12 239, condoms; $12 879, pill). Women who are considering use of LARC methods should receive comprehensive contraceptive counseling, as women who receive counseling before use demonstrate higher rates of after-use method satisfaction, continuation and acceptance than those who do not.
Authors:
P D Blumenthal; A Voedisch; K Gemzell-Danielsson
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Publication Detail:
Type:  Journal Article     Date:  2010-07-15
Journal Detail:
Title:  Human reproduction update     Volume:  17     ISSN:  1460-2369     ISO Abbreviation:  Hum. Reprod. Update     Publication Date:    2011 Jan-Feb
Date Detail:
Created Date:  2010-12-14     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9507614     Medline TA:  Hum Reprod Update     Country:  England    
Other Details:
Languages:  eng     Pagination:  121-37     Citation Subset:  IM    
Affiliation:
Department of Obstetrics & Gynecology, Stanford University, 300 Pasteur Drive, HH-333, Stanford, CA 94305-5317, USA.
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