Who is using long-acting reversible contraceptive methods? Findings from nine low-fertility countries

Perspect Sex Reprod Health. 2014 Sep;46(3):149-55. doi: 10.1363/46e1914. Epub 2014 Jul 14.


Context: Long-acting reversible contraceptive (LARC) methods-IUDs and implants-are more effective than other reversible methods, yet are little used in the United States. Examining which U.S. women use LARC methods and how they differ from users in other low-fertility countries may help point the way toward increasing use.

Methods: Data from married or cohabiting women participating in the National Survey of Family Growth (2008-2010) and in eight countries' Generations and Gender Programme surveys (2004-2010) were used in bivariate and multinomial logistic regression analyses examining LARC use within each setting.

Results: The proportion of contraceptive use accounted for by LARC methods was generally greater in Europe (10-32%) than in the United States (10%) and Australia (7%). Compared with LARC use among comparable groups in other countries, use was particularly low among U.S. women who were married, were aged 40-44 or had had three or more children, yet was comparatively high among 18-24-year-olds. Among U.S. women, those aged 35-39 or 40-44 were more likely than 18-29-year-olds to rely on sterilization rather than on LARC methods (odds ratios, 3.0 and 10.7, respectively), those who had had three or more children were more likely to do so than were those who had had none or one (4.9), and women who had completed college were less likely than those who had not finished high school to do so (0.4).

Conclusions: Certain subgroups of U.S. women may benefit from the reversibility and effectiveness of LARC methods.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adolescent
  • Adult
  • Age Factors
  • Australia
  • Birth Rate
  • Contraception Behavior / statistics & numerical data*
  • Contraceptive Agents, Female / therapeutic use*
  • Drug Implants / therapeutic use*
  • Educational Status
  • Europe
  • Female
  • Humans
  • Intrauterine Devices / statistics & numerical data*
  • Marital Status
  • Parity
  • Sterilization, Reproductive / statistics & numerical data
  • United States
  • Young Adult


  • Contraceptive Agents, Female
  • Drug Implants