Opportunity, satisfaction, and regret: Trying long-acting reversible contraception in a unique scientific circumstance

ABSTRACT

Increased use of long-acting reversible contraception (LARC) can reduce unintended pregnancies. However, significant barriers exist to LARC uptake, particularly high up-front costs. In North Carolina in 2014, we interviewed thirty-four purposively selected participants (aged 20–30 years) enrolled in a partially randomized patient preference trial to learn about their experiences with and attitudes toward contraception in this unique trial context. Cost of LARC was important in participants’ decision-making. Experiencing an unintended pregnancy motivated women to switch to LARC. No participants who tried LARC, even those who experienced side effects, regretted it. Several participants regretted discontinuing their LARC. Concerns about insertion and removal did not influence future willingness to try LARC. Participants discussed the importance of affordability and feeling in control when choosing a contraceptive method. Cost, combined with uncertainty over whether LARC is the right method for them, may deter young women from trying LARC. Intrauterine devices (IUDs) and implants should be made affordable so that women can try them without significant financial commitment. Affordability will likely increase uptake, which will reduce unintended pregnancies. Regret from discontinuing LARC was more frequently reported than regret from trying LARC. Providers should offer young women LARC and counsel to support continuation.

KEYWORDS:

• Adolescent
• attitudes
• beliefs
• contraception
• cost
• long-acting reversible contraception
• regret
• young women

Acknowledgments

We would like to acknowledge Ariana Katz for coding transcripts and Natasha Mack for her editorial review of the manuscript.

Additional information

Funding

Primary funding for this research study was provided by the Eunice Kennedy Shriver National Institute of Child Health & Human Development of the National Institutes of Health under Award Number R01HD067751. In addition, this grant received product donations from Teva Pharmaceuticals, Bayer HealthCare Pharmaceuticals, Inc., and Merck Sharp & Dohme Corp. Finally, an anonymous donor provided additional funding. This study is registered on ClinicalTrials.gov (NCT01299116). The content of this report is solely the responsibility of the authors and does not necessarily represent the views of the funders, FHI 360, Planned Parenthood Federation of America, Inc., or Planned Parenthood South Atlantic, Inc; Eunice Kennedy Shriver National Institute of Child Health and Human Development [R01HD067751]; Merck Sharp and Dohme; Bayer HealthCare Pharmaceuticals, Inc.; Teva Pharmaceuticals; anonymous donor.