Department of Biostatistics and Epidemiology, and School of Public Health, University of North Texas Health Science Center, Fort Worth, Texas, USA.
Department of Health Behavior and Health Systems, School of Public Health, University of North Texas Health Science Center, Fort Worth, Texas, USA.
J Womens Health (Larchmt). 2022 May;31(5):733-740. doi: 10.1089/jwh.2021.0272. Epub 2022 Jan 7.
Long-acting reversible contraceptives (LARCs) are highly effective forms of contraception, which can reduce the risk of unintended pregnancy. Despite LARC effectiveness, women may desire to discontinue this method. This study will examine reasons for intent to discontinue and remove LARCs among U.S. women 15-49 years of age from 2017 to 2019. The National Survey of Family Growth 2017-2019 was utilized with a sample of 6141 female respondents. Descriptive statistics for intention to discontinue LARCs, difficulty removing LARCs, and reasons for LARC discontinuation and removal were examined. Rao-Scott chi-square tests were conducted in SAS. Overall, 22.9% of women reported ever using LARCs. Among LARC users, most women (81.2%) reported using LARC in the past 10 years. Among these women, 63.9% intended to discontinue LARCs, and 11.5% had difficulty removing LARCs. Reasons for wanting to discontinue LARCs include side effects (29.6%), LARC expiration (26.8%), LARC complications (19.3%), and decided to get pregnant (15.9%). Primary reasons reported for difficulty removing LARCs included: complications (68.3%), other reasons (13.4%), discouragement by provider (5.8%), and provider's inability to remove (4.9%). Given that women who use a LARC method rely on providers to remove this contraceptive method, understanding the reasons for discontinuation and difficulties encountered is needed. Findings from this nationally representative sample identified provider-level and system-level barriers for LARC removal. To respect the reproductive autonomy of LARC users' method for pregnancy prevention, these barriers must be overcome.
长效可逆避孕措施（LARC）是一种非常有效的避孕方法，可以降低意外怀孕的风险。尽管 LARC 效果显著，但女性可能希望停止使用这种方法。本研究旨在探讨 2017 年至 2019 年期间美国 15-49 岁女性停止使用 LARC 的原因和取出 LARC 的情况。本研究使用了 2017-2019 年全国家庭增长调查的数据，样本量为 6141 名女性受访者。本研究对停止使用 LARC 的意向、取出 LARC 的困难程度以及停止和取出 LARC 的原因进行了描述性统计分析。Rao-Scott 卡方检验在 SAS 中进行。总体而言，22.9%的女性报告曾使用过 LARC。在 LARC 使用者中，大多数女性（81.2%）在过去 10 年内使用过 LARC。在这些女性中，63.9%打算停止使用 LARC，11.5%取出 LARC 存在困难。想要停止使用 LARC 的原因包括副作用（29.6%）、LARC 过期（26.8%）、LARC 并发症（19.3%）和决定怀孕（15.9%）。取出 LARC 困难的主要原因包括：并发症（68.3%）、其他原因（13.4%）、提供者劝阻（5.8%）和提供者无法取出（4.9%）。鉴于使用 LARC 方法的女性依赖提供者来取出这种避孕方法，因此需要了解停止使用和遇到的困难的原因。这项具有全国代表性的样本研究确定了 LARC 取出的提供者层面和系统层面的障碍。为了尊重 LARC 用户避孕方法的生殖自主权，必须克服这些障碍。
