June 18, 2015 — Training reproductive health clinic staff on how to counsel women about long-acting reversible contraceptives can help cut unintended pregnancy rates among women seeking contraceptive counseling by nearly half, according to a study published Tuesday in The Lancet, Reuters reports.
For the study, researchers at the University of California-San Francisco assessed 40 Planned Parenthood clinics between 2011 and 2013 (Seaman, Reuters, 6/16). The clinics were located across 15 states (Aliferis, "State of Health," KQED, 6/16).
The researchers assigned half of the clinics to undergo training on how to counsel women about two types of LARCs -- intrauterine devices and progestin implants -- and insert them. Meanwhile, the remaining clinics did not receive the additional training.
Researchers then analyzed questionnaire data from 1,500 women who attended the clinics for pregnancy prevention or abortion services (Reuters, 6/16). To participate in the study, eligible women ages 18 to 25 indicated that they wanted counseling on birth control and wanted to avoid becoming pregnant ("State of Health," KQED, 6/16).
According to the questionnaire results, about 71% of women who went to clinics that received training said they were told about LARC methods, compared to 39% of women who were treated at clinics that did not undergo the additional training (Reuters, 6/16). About 28% of women visiting the clinics with additional training opted to use a LARC method. In contrast, roughly 17% of woman at the clinics without the additional training opted for such contraceptive methods ("State of Health," KQED, 6/16).
Overall, the researchers found that the pregnancy rate among women seeking contraceptive counseling at the clinics with additional training was about 8%, while the pregnancy rate among such women at the clinics without LARC training was about 15%. However, they said there was no difference in the pregnancy rate for women seeking abortion care at the trained and untrained clinics (Reuters, 6/16).
According to the researchers, only 44% of women who opted for LARCs after an abortion obtained them ("State of Health," KQED, 6/16).
Cynthia Harper, from the Bixby Center for Global Reproductive Health at UCSF and the study's lead author, said the unchanged pregnancy rate among women seeking abortion care could be linked to restrictions that prevent women from receiving birth control and abortion care on the same day. "Policies and restrictions aimed at abortion have this spillover effect," she said (Reuters, 6/16).
Harper said study participants also cited costs as a barrier to LARCs. According to "State of Health," an IUD can cost up to $1,000. However, the researchers noted that the study was conducted before the Affordable Care Act (PL 111-148) was fully implemented, and 38% of women in the study did not have health insurance at the time.
Harper said, "I'm hopeful that if the ACA is in place and if women are more likely to be insured for contraceptives, then they'll be able to afford these methods that have higher upfront costs" ("State of Health," KQED, 6/16).