Home' Trinidad and Tobago Guardian : June 23rd 2015 Contents A28
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Guardian www.guardian.co.tt Tuesday, June 23, 2015
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Women are more likely to choose to get IUDs
and other highly effective contraceptives at family
planning clinics if the clinicians there have been
educated about these methods, according to a new
The increase in the use of long-acting reversible
contraceptives---IUDs (intrauterine devices) and sin-
gle-rod hormonal implants in the arm---were asso-
ciated with nearly 50 per cent fewer unintended
pregnancies among the women in the study.
Long-acting reversible contraceptives (LARCs)
are considered the most effective method of con-
traception, associated with failure rates of less than
one per cent, whereas birth control pills and condoms
have failure rates of nine per cent and 18 per cent,
respectively. However, LARCs are often not available
or discussed in clinics, said Cynthia C Harper, pro-
fessor at obstetrics, gynecology and reproductive
sciences at the University of California, San Francisco
School of Medicine.
Harper and her colleagues tested whether edu-
cating providers about LARCs, how to insert them
and how to talk with women about them would
lead to increased use of this method and decreased
rates of unintended pregnancies among their patients.
The researchers gave half-day training sessions to
providers at 20 Planned Parenthood clinics in 15
states across the US; they compared these inter-
vention sites to another 20 control clinics where
the staff did not receive training.
The researchers looked at the effects in 1,500
women ages 18 to 25. The women were either visiting
the clinics for help with family planning or there
to get an abortion, and were thus at high risk of
having an unintended pregnancy.
"Our main impetus for doing this study was to
try to address the very high rates of unintended
pregnancies in the US, over half of all pregnancies,
and that s been the case for decades with no
progress," said Harper who is the lead author of the
study, published this week in the Lancet journal.
Twenty-eight percent of the women in the study
who visited an intervention clinic decided to get an
IUD or implant compared with 17 per cent of the
women who visited a control clinic. "I was happy
with that (increase)",
Harper said. "I think a lot of women were learning
about these methods for the first time (and) if they
hear about them from a few different places and
people, they might become more familiar with them
and want to use them."
Along with the increase in use of LARCs, the
researchers saw a decrease of nearly 50 per cent in
the number of unintended pregnancies in the fol-
lowing year among the women who visited an inter-
vention clinic for family planning compared with
a control clinic. But there was no difference in the
number of unintended pregnancies among women
who visited an intervention clinic for an abortion.
The study found that 56 per cent of the women
who just got an abortion were not able to get a
LARC, compared with 27 per cent of women in the
family planning group. It may have been difficult
for women to afford the procedure to implant a
LARC on the same day as paying for an abortion,
or clinics may not have been willing to do the
implantation and abortion in the same visit, Harper
Although Planned Parenthood clinics often have
sliding scales to help cover the implantation pro-
cedure, which can be US$800 to US$1,000 out of
pocket, the cost can still be substantial, Harper said.
Still, the contraception lasts three to five years and
is more affordable over that time than birth control
pills, she said.
The inconvenience of having to come back on
another day to receive a LARC could keep a lot of
women who just got an abortion, and who are at high
risk of having another unintended pregnancy, from
getting the device, Harper said.
It was "impressive" that the researchers trained the
providers not just in how to implant a LARC but also
in how to counsel women about them, what they are,
how effective they are and their side effects, said
Laureen Lopez, scientist at fhi360, a nonprofit human
development organisation that conducts research and
programing in health, education and other areas.
Ounce of training worth a
pound of pregnancy prevention
YOUR DAILY HEALTH
News and Advice
failure rates of
less than one
control pills and
failure rates of
nine per cent
and 18 per cent,
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