Beyond a Legacy of Coercion: Long-Acting Reversible Contraception (LARC) and Social Justice

Abstract

One half of all pregnancies in the United States are unintended. The American College of Obstetricians and Gynecologists has recommended long-acting reversible contraception (LARC) as first-line pregnancy prevention for all women and adolescent girls. However, continued reproductive coercion in the U.S., especially among underserved populations, problematizes the promotion of LARC methods. We conducted six focus groups (n = 61) and 18 interviews with women ages 18–44 years to explore the impact of coercion on women’s perspectives of LARC methods and messages about LARC. Findings suggest the importance of identity in how women make meaning of LARC methods. Identification with women who use LARC methods influenced participants’ understanding of contraceptive choice. Lack of information provided by health care providers about LARC served as a barrier to method knowledge. Findings from this study offer theoretical and practical opportunities to guide health care practitioners and health communication campaigns aimed at decreasing the burden of unintended pregnancy while maintaining reproductive justice.

Keywords:

• Long-acting reversible contraceptives (LARC)
• IUD
• implant
• social justice
• reproductive coercion
• qualitative methods

Acknowledgments

The authors would like to acknowledge the members of the College of Charleston’s Women’s Health Research Team for their contributions to this study, including data collection, and for their continued support.

Disclosure statement

The authors have no conflicts to report.

Additional information

Funding

This research was supported in part by the College of Charleston’s Faculty Research and Development Grant, Health and Human Performance Research and Development Grant, Humanities and Social Sciences Dean’s Discretionary Funds, and the Office of Undergraduate Research and Creative Activities.