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Manchikanti Gomez, Anu, Liza Fuentes, and Amy Allina. “Women or LARC First? Reproductive Autonomy And the Promotion of Long-Acting Reversible Contraceptive Methods.” Perspectives on Sexual Reproductive Health 46, no. 3 (September 2014): 1–5.


In this article the authors discuss how women are impacted by the long-acting reversible contraceptive (LARC) methods. LARC methods (also known as IUDs and implants) “have not been an option that women could easily choose, because of a range of barriers: lack of knowledge, providers’ low familiarity and lack of training, cost and unavailability in clinic” (1). The authors argue that barriers associated with LARC should be reduced but not completely eliminated because they undermine women’s reproductive autonomy. Furthermore, the authors hope that programs that are designed to promote LARC methods rearrange their priorities to place the needs and preferences of individual women instead of the promotion of specific technologies. Historically consumers of LARC methods have been women of color who represent the “high-risk” populations. According to the authors, when providers are offering contraceptives to their patients more than often they “consider race and socioeconomic status in making their recommendations about the most appropriate contraceptive” (1). This demonstrates that there are social and reproductive health inequalities. Another issue with the LARC method is that they are unaffordable for those who are low-income to both insert and remove. However, for health providers LARC methods are viewed as the most effective because the control and regulate women’s reproductive cycles and bodies. An implication with LARC methods is that some providers will choose not to remove a contraceptive, simply because the timing is too early, or because the woman does not have the money to pay to remove it, thus violating the woman’s reproductive autonomy. The authors conclude their article by suggesting recommendations for improving the delivery of LARC services while also promoting their reproductive autonomy. Two recommendations they offer are “policy barriers to both LARC insertion and removal be eliminated” and that “the cost of device removal is automatically covered at the time of insertion.” (4). The authors hope that with LARC women will have the ability to prevent and plan pregnancies by their own choices and with their own reproductive autonomy, instead of by the choices and decision of others.


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Race/ethnicity: African American/Black   Contraception/birth control   Race/ethnicity: Latina/Hispanic