Burke Holly M, Packer Catherine A, Spector Hannah L, Hubacher David
a Reproductive, Maternal, Newborn and Child Health Division , Durham , North Carolina , USA.
b Planned Parenthood South Atlantic , Raleigh , North Carolina , USA.
Women Health. 2019 Mar;59(3):266-280. doi: 10.1080/03630242.2018.1478363. Epub 2018 Aug 1.
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.
长效可逆避孕法（LARC）使用的增加可以减少意外怀孕。然而，LARC的采用存在重大障碍，尤其是前期成本高昂。2014年在北卡罗来纳州，我们采访了34名经过有目的选择的参与者（年龄在20至30岁之间），他们参与了一项部分随机的患者偏好试验，以了解他们在这个独特试验背景下使用避孕方法的经历和态度。LARC的成本在参与者的决策中很重要。经历意外怀孕促使女性转而使用LARC。没有尝试过LARC的参与者，即使是那些经历过副作用的人，也不后悔。有几位参与者后悔停止使用LARC。对放置和取出的担忧并未影响未来尝试LARC的意愿。参与者讨论了在选择避孕方法时可承受性和掌控感的重要性。成本，再加上不确定LARC是否适合自己，可能会阻碍年轻女性尝试LARC。宫内节育器（IUD）和植入物应降低成本，以便女性在无需重大经济投入的情况下尝试使用。可承受性可能会增加其采用率，从而减少意外怀孕。报告显示，停止使用LARC后的后悔比尝试使用LARC后的后悔更为常见。医疗服务提供者应向年轻女性提供LARC并提供咨询以支持其持续使用。
