Women or LARC First? Reproductive Autonomy And the Promotion of Long‐Acting Reversible Contraceptive Methods

Do Knowledge and Attitudes Regarding Intrauterine Devices Predict Interest in Their Use?

“…Many of the study findings have potentially important implications for efforts to promote IUD use among young women, particularly in the context of firstline or directive counseling that emphasizes method effectiveness over other contraceptive features (Gomez, Fuentes, & Allina, 2014;Higgins, 2014). Though these results should be interpreted with caution given the sample was primarily White, educated and insured, it is notable that even women who are not considered the most vulnerable to unintended pregnancy had low levels of interest in using an IUD in the future.…”

Realizing Reproductive Health Equity Needs More Than Long-Acting Reversible Contraception (LARC)

“…The choice of a contraceptive method is a personal decision and therefore highly contextual. 6 Positioning any method as "the first-line" choice invites a lack of regard for the preferences of people who have the capacity to become pregnant. The authors write that the reasons for low usage of LARC are primarily due to "knowledge gaps, access issues, and confidentiality," but do not appear to consider other factors in decisions around usage.…”

Structural Competency and Reproductive Health

“…The CDC states that familiarity with social determinants of health data can help practitioners better recognize "root causes" [15], which health care professionals can miss if they only rely upon individual-level assessment and interventions [16]. Amidst calls for health care institutions to play a role in eliminating reproductive health disparities and in incorporating social determinants of health into practice [17], scholars argue that reproductive health care operates within paradigms that directly and indirectly create or exacerbate reproductive health disparities [2,3,18,19].…”

“…Here, public health policies underlay the connections between individual patient characteristics (e.g., being Mexican, low income) and the perceived social danger of overpopulation. Beyond Quilligan, examples of health care practices and policies that replicate reproductive oppression and impede care for many women include the twentieth century's forced sterilization of poor and working-class women, disabled women, and women of color [22] and the coercive sterilization of at least 148 women in California prisons between 2006 and 2010 [23]; long-acting reversible contraception (LARC) promotion targeting racial or ethnic minority and poor women without regard for the ways that this might invoke population control [3]; and state family cap policies that deny cash benefits to children born in families already receiving benefits [24].…”

“…Reproductive health care's success in advancing this vision is mixed [2,3], suggested by persistent reproductive health disparities in the US, particularly with respect to race, gender, and socioeconomic status. Women of color and low-income women fare worse than their white and higher-income counterparts in nearly every aspect of reproductive health, including access to prenatal care [4], maternal mortality [5], cervical cancer mortality [6], sexually transmitted infections [7,8], access to services (including assisted reproductive technologies) [2], and education [4].…”