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Just for Mom: Reversible Contraceptions

Maybe you’re done having children – or maybe not. There are a number of reasons why women choose long-acting reversible contraception (LARCs). Some have nothing at all to do with birth control.

Katie Isham, an OB-GYN with Prisma Health-Upstate, said there are several options for birth control that are not permanent, but that are conducive to a busy life. Women should consult with their doctor to determine if a LARC is right for them, to discuss any potential side effects or health concerns and to be fully informed about what is best for their family planning and health.

“LARCs are exactly what the name implies,” she said. “They are methods of preventing pregnancy that you don’t have to remember every day, every week, every month.”

One option is Nexplanon, a small implant that is placed under the skin of the arm in a quick office procedure. Isham said it lasts up to 3 years but can be removed at any time.

Other LARCs are intrauterine devices (IUDs) that can be hormonal or nonhormonal, depending on type. They are placed inside the uterus 

A nonhormonal, copper IUD can last up to 10 years and is removable at any time.

“That’s a good option for somebody who wants to avoid hormones,” Isham said. 

Hormonal IUDs come in four different types, which differ in size and dose, Isham said. They are often used for reasons other than preventing pregnancy.

“We talk a lot about the non-contraceptive benefits,” Isham said. “I use them frequently for women with really heavy periods.”

Isham said they can significantly improve heavy bleeding. 

Unlike the IUDs of decades ago, Isham said current types can be used in women who have never had a baby – even in women who have never had sexual intercourse – and in teenagers. 

“I generally think that LARC devices are good for almost any woman who wants birth control, specifically those who want to set and forget it,” she said. “There are some abnormalities of the uterus that might be a contraindication of an IUD.”

Women with an active pelvic infection and those with abnormal bleeding with an unknown cause would also not be able to get an IUD without treatment.

And some women have conditions that will be better suited by other forms of birth control. Family cancer history might be considered as well, since the risk of some, such as ovarian cancer, might be reduced by specific medications, including birth control pills. 

LARCs are typically well covered by Medicaid, according to Isham, and most private insurance carriers. 

“LARC devices are the most effective way to prevent pregnancy,” Isham said. “They are as effective as getting your tubes tied.”