Higgins Jenny A
University of Wisconsin, Madison, WI 53706, USA.
Contraception. 2014 Apr;89(4):237-41. doi: 10.1016/j.contraception.2014.01.027. Epub 2014 Feb 10.
Recent years have witnessed an outpouring of research and funding pertaining to long-acting reversible contraception (LARC). The time is ripe to contextualize LARC’s hype within our broader reproductive health goals and tools—that is, how we can best address the needs of individuals who benefit from the reproductive health services we provide. After reviewing LARC’s major benefits, this commentary presents three potentially problematic aspects of LARC promotion: 1) the notion that increasing LARC use could singlehandedly end unintended pregnancies and their associations with poverty, 2) the clinical emphasis on LARC methods over all others, and 3) inadvertently failing to acknowledge the ways in which poor women of color will experience LARC promotion through legacies of racism and eugenics. The comment concludes by highlighting the benefits of a reproductive justice approach to LARC: an approach devoted to making LARC affordable and accessible while simultaneously respecting women’s decisions to use LARC, their ability to have LARC removed when they wish, and their ability to determine for themselves where contraception and pregnancies fit into their lives.
近年来,关于长效可逆避孕法(LARC)的研究和资金投入大量涌现。现在是时候将LARC的热潮置于更广泛的生殖健康目标和工具背景下进行考量了,也就是说,我们如何才能最好地满足那些受益于我们所提供生殖健康服务的个人的需求。在回顾了LARC的主要益处之后,本评论提出了LARC推广中三个潜在的问题方面:1)认为增加LARC的使用可以单独终结意外怀孕及其与贫困的关联;2)临床实践中对LARC方法的重视超过其他所有方法;3)无意中未能认识到有色人种贫困女性将如何通过种族主义和优生学的遗留影响来体验LARC推广。评论最后强调了采用生殖正义方法对待LARC的益处:这种方法致力于使LARC价格可承受且易于获得,同时尊重女性使用LARC的决定、她们在希望时取出LARC的能力,以及她们自行决定避孕和怀孕在其生活中所处位置的能力。