Abstract

BackgroundAustralia has high rates of teenage pregnancy compared with many Western countries. Long-acting reversible contraception (LARC) offers an effective method to help decrease unintended pregnancies; however, current uptake remains low. The aim of this study was to investigate barriers to LARC use by young women in Australia.MethodsHealthcare professionals were recruited through publicly available sources and snowball sampling to complete an interview about young women’s access to and use of LARC. The sample consisted of general practitioners, nurses, medical directors of reproductive and sexual health organisations, a sexual health educator, and health advocates. In addition, four focus groups about LARC were conducted with young women (aged 17–25 years) recruited via health organisations and a university. The data were analysed thematically.ResultsFifteen healthcare professionals were interviewed and four focus groups were conducted with 27 young women. Shared barriers identified included norms, misconceptions, bodily consequences, and LARC access issues. An additional barrier identified by young women was a perceived lack of control over hormones entering the body from LARC devices. Healthcare professionals also raised as a barrier limited confidence and support in LARC insertions. Strategies identified to increase contraceptive knowledge and access included increasing nurses’ role in contraceptive provision and education, improving sex education in schools, and educating parents.ConclusionsChallenges remain for young women to be able to make informed choices about contraception and easily access services. More research is needed around innovative approaches to increase LARC knowledge and access, including examining the role of nurses in enhancing young women’s reproductive health.

Highlights

  • Australia has high rates of teenage pregnancy compared with many Western countries

  • Poor access to contraception and contraceptive failure due to poor adherence contributes to high unintended pregnancy and abortion rates among young women in Australia compared with many Western countries [1]

  • We identified the following groups as those most closely involved in the provision of Long-acting reversible contraception (LARC) to young women: general practitioners, nurses with professional experience and knowledge around young women’s reproductive health, directors of sexual and reproductive health services, sexual health educators and health advocates

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Summary

Introduction

Australia has high rates of teenage pregnancy compared with many Western countries. Long-acting reversible contraception (LARC) offers an effective method to help decrease unintended pregnancies; current uptake remains low. Poor access to contraception and contraceptive failure due to poor adherence contributes to high unintended pregnancy and abortion rates among young women in Australia compared with many Western countries [1]. Long-acting reversible contraception ([LARC] i.e. contraceptive implant and intrauterine devices), which do not require daily adherence, offer an effective method to help decrease unintended pregnancies. Studies such as the Contraceptive CHOICE Project in the United States have demonstrated high efficacy, acceptability and continuation rates of LARC. In the Contraceptive CHOICE Project, women were provided with standardised contraceptive counselling and offered the contraceptive method of their choice free of charge [6]

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