Obstet Gynecol. 2009 Dec;114(6):1434-1438. doi: 10.1097/AOG.0b013e3181c6f965.
High unintended pregnancy rates in the United States may in part be the result of relatively low use of long-acting reversible contraceptive (LARC) methods, specifically the contraceptive implant and intrauterine devices. Top-tier reversible methods share the characteristic of requiring a single act of motivation for long-term use, eliminating adherence and user-dependence from the effectiveness equation. According to the World Health Organization's evidence-based Medical Eligibility Criteria for contraceptive use, LARC methods have few contraindications, and almost all women are eligible for implants and intrauterine devices. Because of these advantages and the potential to reduce unintended pregnancy rates, LARC methods should be offered as first-line contraceptive methods and encouraged as options for most women. To increase use of LARC methods, barriers such as lack of health care provider knowledge or skills, low patient awareness, and high upfront costs must be addressed.
美国意外怀孕率居高不下，部分原因可能是长效可逆避孕（LARC）方法的使用率相对较低，尤其是避孕植入物和宫内节育器。顶级可逆避孕方法的一个共同特点是，只需一次动机即可长期使用，从而将避孕方法的有效性与坚持使用和使用者依赖性脱钩。根据世界卫生组织基于证据的避孕方法医学资格标准，LARC 方法几乎没有禁忌症，几乎所有女性都适合使用植入物和宫内节育器。由于这些优势以及降低意外怀孕率的潜力，LARC 方法应该作为首选避孕方法提供，并鼓励大多数女性选择。为了增加 LARC 方法的使用，必须解决一些障碍，如医护人员知识或技能的缺乏、患者意识低以及前期成本高。
