Maternal and Child Health

Long-Acting Reversible Contraception (LARC)

Long-acting reversible contraception (LARC) is safe and highly effective in preventing unintended pregnancies. Unlike other forms of birth control, LARC requires no user intervention, works over long periods of time, and can be reversed. LARC includes intrauterine devices (IUDs) and contraceptive implants that prevent ovulation.

ASTHO is working to identify the opportunities, challenges, and technical assistance needs of states through a multi-state learning community to improve the capacity of states to successfully implement LARC, particularly immediately postpartum.

Request for Proposals (RFP) Increasing Access to Contraception Learning Community

ASTHO is requesting proposals for the evaluation of the Increasing Access to Contraception Learning Community. Expected products include a completed process evaluation, Key Informant Interviews with Cohort 3 states, return on investment analysis, and the development of assessment and evaluation tools for participating states to monitor policy uptake, lessons learned and barriers to increasing access to contraception. Proposals are due by Nov. 30, 2016, at 11:59 p.m. ET. Please contact Christi Mackie at cmackie@astho.org with any questions.

Immediately Postpartum Learning Community

ASTHO launched the LARC Learning Community, a collaborative of six states, in August 2014 to assist state health agencies in implementing LARC, specifically via initiatives focusing on postpartum insertion following delivery. The following materials document the launch of years 1 and 2 of the learning community and the results of “key informant interviews” to assess challenges and barriers to increase LARC access.

Year 1 (2014)

Year 2 (2015)

Learning community call recordings and presentations »

Guidance and Strategies for Implementing LARC

Factsheet on Long-Acting Reversible Contraception and Breastfeeding
Research and recommendations on LARC use during breastfeeding.

Factsheet on Long-Acting Reversible Contraception (LARC)
What is long-acting reversible contraception? What are the benefits of its use? What are the barriers for people in accessing it?  

Eight Strategies for Success
Eight areas identified by the LARC learning community to increase access to LARC immediately postpartum.

LARC Immediately Postpartum and Service Locations
Providing immediate postpartum LARCs in the four most common settings.

LARC Payment and Reimbursement: Device Payment Strategies for Providers Factsheet
Covering the cost of LARC devices is critical to increasing women’s access.

LARC Partnering to Increase Access and Coverage for Teens and Postpartum Women (webinar) | slide deck
Featuring presentations from Colorado, Iowa, and South Carolina.

State Story: Oklahoma Secures Private Funding for LARC
To reduce the state’s high rates of teen births and unplanned pregnancies, the Oklahoma Health Care Authority sought funding from foundations to increase the use of long-acting reversible contraception.

Delaware Public-Private Partnership for Comprehensive Birth Control Initiative
Delaware Addresses High Unintended Pregnancy Rate Through a Public-Private Partnership and Comprehensive Birth Control Initiative.

IPP LARC State Monitoring Tool
A simple tool to calculate immediate postpartum LARC implementation measures using Medicaid claims data.

Complex IPP LARC State Monitoring Tool
A tool to calculate IPP LARC implementation measures using Medicaid claims data, with capabilities to adjust for patient or facility-related variables.

Leadership and Immediate Postpartum LARC
This factsheet profiles how leaders in state public health, Medicaid, and the healthcare provider community, can help move immediate postpartum LARC forward.

Informed Consent and Ethical Considerations for Immediate Postpartum LARC
This factsheet provides an introduction to some of the considerations to keep in mind regarding informed consent and ethics related to immediate postpartum LARC.

Recently Published Journal Articles by ASTHO Staff

ASTHO staff seek opportunities to share findings, guidance, and strategies for LARC implementation by state health agencies in academic and profession-focused journals and publications.

Application of Implementation Science Methodology to Immediate Postpartum Long-Acting Reversible Contraception Policy Roll-Out Across States
Maternal and Child Health Journal, April 2016 (Subscription access is needed)

Working with State Health Departments on Emerging Issues in Maternal and Child Health: Immediate Postpartum Long-Acting Reversible Contraceptives
Journal of Women's Health, September 2015 (Subscription access is needed)

Medicaid Reimbursement Policies for LARC Aid Awareness, Use
National Institute for Children's Health Quality (NICHQ) blog, July 29, 2015

Educating Healthcare Workers on IUDs, Implants Halves Unintended Pregnancies, Study Finds
StatePublicHealth.org, June 19, 2015

States Work to Improve Postpartum LARC Implementation
Association of Maternal and Child Health Programs - AMCHP Pulse, May/June 2015

LARC Now Considered a Top Method to Prevent Unintended Pregnancy
StatePublicHealth.org, Dec. 19, 2014