Disparities in the Use of Long-Acting Reversible Contraception (LARCs): Exploring the Roles of Women’s Preferences and Clinician Behaviors

Abstract

This thesis sought to understand why women who are seeking to delay pregnancy, especially those at high risk of unintended pregnancy, are not using the most effective forms of contraceptive, namely Long-Acting Reversible Contraception (LARCs). Using a mixed-method analysis, this study examined the ways in which women’s preferences and clinician behaviors shape disparities in contraceptive use. Misinformation and lack of awareness were the main reasons why women did not want to use LARCs. Results from logistic regression analysis revealed that women with higher levels of educational attainment were significantly more likely to prefer LARCs. There was strong evidence that clinicians are more likely to counsel and prescribe LARCs to married respondents and highly educated respondents, which is troubling because these groups are at low risk of having an unintended pregnancy. Potential interventions to increase LARC use are discussed.