Barriers and reasons for initiating the use of long-acting reversible contraceptives (LARC) in a cohort of Brazilian women

Abstract

Identify barriers and reasons for initiating the use of long-acting reversible contraceptive (LARC) methods in a cohort of Brazilian women. A cross-sectional study surveyed women aged 18–49 attending a tertiary Family Planning clinic for long-acting reversible contraception (LARC). A tailored questionnaire gathered information on demographics, contraceptive preferences, motivations for choosing LARC and challenges in obtaining their preferred method. we revised it to: The participants had a mean age of 29.5 years (SD = 8.0). Nearly half (47.9%) were between 20 and 29 years old. The sample was predominantly composed of non-white women (600, 50.5%), the majority of whom were single (56.0%), had completed 10 to 12 years of schooling (56.9%), and 56.9% came from a region outside Campinas. Among the 1,193 women 965 (81.2%) choose the levonorgestrel 52 mg IUD, whereas 43 (3,6%) chose the etonogestrel implant, and 164 (13,79%) the copper-IUD. The primary motivations for seeking LARC at a tertiary clinic included lack of availability at Primary Basic Units, free of cost, and presence of trained healthcare providers. The main reasons for choosing the SIU-levonorgestrel 52 mg were high efficacy, bleeding control, and preference for achieving amenorrhea. Social disparities, limited availability, lack of trained health care hinder awareness and access to LARCs. In conclusion, the key barriers identified were the lack of availability of preferred LARC methods in public healthcare facilities and the considerable delay between a woman’s decision to use contraception and its actual initiation.