Changes in the Use of Long-Acting Reversible Contraceptive Methods Among U.S. Nulliparous Women: Results from the 2006-2010, 2011-2013, and 2013-2015 National Survey of Family Growth

Abstract

Objective: Nulliparous women in the United States have high rates of unintended pregnancy comparable with parous women. Long-acting reversible contraceptives (LARCs) are recommended as first-line contraceptive choices to reduce unintended pregnancy. However, use of LARCs among nulliparous women has been low. This study aims to examine changes in the prevalence of current LARC use among sexually experienced U.S. nulliparous women across the time period of 2006-2010, 2011-2013, and 2013-2015, and examine correlates of use.

Materials and methods: Sexually experienced nulliparous women (15-44 years) from the 2006-2010, 2011-2013, and 2013-2015 rounds of the National Survey of Family Growth (N = 7463) were examined. Changes in the prevalence of current use of LARCs were examined and correlates of current LARC use were evaluated using multiple logistic regression.

Results: Increases in the prevalence of current LARC use from 2008 to 2012 (0.8% vs. 3.8%, p < 0.0001) and from 2012 to 2014 (3.8% vs. 5.7%, p = 0.09) were observed among sexually experienced nulliparous women. Significant increases were also observed across different subgroups of nulliparous women. Maternal age, education, future birth intention, sexual activity, and discontinuation of non-LARC hormonal contraceptives due to dissatisfaction were significant correlates of current LARC use.

Conclusion: Although current use of LARCs among sexually experienced U.S. nulliparous women shows an increasing trend, prevalence of use still remains low. There is the need to increase awareness of LARCs as an effective contraceptive choice for nulliparous women.

Keywords: contraception; long-acting reversible contraceptive; nulliparous.