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Long-Acting Reversible Contraception Use Among Navy and Marine Corps Women

Although women in the military have access to a variety of free contraceptive options, unplanned pregnancies continue to occur in the Department of the Navy (DoN). In 2010, only 36% of pregnancies among surveyed enlisted sailors were planned pregnancies.1 In 2008, among surveyed active duty married and single Marines aged 21-25, 1 of 4 women (25%) and 1 in 10 men (10%) said they personally experienced an unplanned pregnancy in the previous 12 months.2 For Navy and Marine Corps women, an unplanned pregnancy can3:

  • Disrupt a woman's career, educational, training, health, and life goals
  • Impact her military unit due to temporary disqualification from service on ships (after the 20th week), deployments, and other hazardous work settings

Although most military women believe in the importance of family planning and use some form of contraception, most do not use the most effective forms, the long-acting reversible contraceptives (LARCs).1

What are LARCs?

LARCs are birth control methods that provide effective contraception over a long period of time, but do not require any action by the user after they have been inserted. LARCs available in the U.S. and in Navy Medical facilities include:

  • Hormonal implants
    • Implanon and Nexplanon 
  • Intrauterine contraceptives 
    • Paragard, Mirena and Skyla

In general, LARCs are beneficial because they are:

  • Extremely effective in preventing pregnancy (>99% effective)
  • Low maintenance for doctors and users
  • Discreet
  • Long-lasting and provide continuous contraception for 3-12 years
  • Quickly reversible and enable rapid return to fertility after removal
  • Safe for most women, including teens and HIV-positive women
  • Safe for women who have had a cesarean section, sexually transmitted infections (STIs), pelvic inflammatory disease (PID), ectopic pregnancy and for non-monogamous women
  • Well tolerated by adolescents
  • Well-liked by users with over 81% of sailors and marines still using their IUD and over 91% still using their implant after the first year (NMCPHC. Analysis of long-acting reversible contraception (LARC) implantation and extraction among female Sailors and Marines. 2012. Unpublished)
  • Cost-saving when compared to oral contraceptive pills over a five year period
  • Easily placed and removed

Why is it important to discuss LARCs?

Among female Sailors who said they were using birth control when they became pregnant, more than half were using the birth control pill compared to other contraceptive methods.1 Birth control pills are more failure-prone than LARCs. One of the reasons for higher failure rates among oral contraceptives is inconsistent or incorrect use, such as forgetting doses or neglecting to take the pill at the same time every day.4 LARCs eliminate the need for adherence to a medication schedule, therefore reducing the risk of an unintended pregnancy.

What are some common myths surrounding LARC?

Studies have found many myths surrounding the use of LARC.

  • Myth: Birth control pills are as reliable as IUDs and implants.
    Fact: With typical use (use by the average person who does not always use the method correctly or consistently), birth control pills are about 85% effective, while IUDs and implants are over 99% effective. 
  • Myth: LARCs cannot be used by women who have not had a child.
    Fact: LARCs are safe for women who have not had a child and most women experience a rapid return to fertility following removal of LARCs.
  • Myth: IUDs increase the risk of sexually transmitted infections (STIs).
    Fact: Although IUDs do not protect against STIs, they do not increase a woman's risk of getting an STI. Women who are concerned about STIs should use condoms along with the IUD.
  • Myth: LARCs are too expensive.
    Fact: Intrauterine devices and implanted rods are less expensive over a five year period than other forms of contraception, including birth control pills.6

What can you do?

Unplanned pregnancies can negatively affect a Sailor or Marine's career, finances and relationships, making the prevention of unplanned pregnancies a necessary component of their overall health and wellness. Despite the effectiveness and relative ease of use of LARCs, usage among military women is very low. In 2010, only 15% of enlisted women who used contraception cited LARC as their chosen form of birth control.1

Learn more about LARCs by checking out the Navy and Marine Corps Public Health Center's LARC web page at: http://www.med.navy.mil/sites/nmcphc/health-promotion/reproductive-sexual-health/Pages/contraception.aspx

References

1. Navy Personnel Research, Studies, and Technology. 2012 Navy pregnancy and parenting survey. Navy Personnel Research, Studies, and Technology. http://www.public.navy.mil/bupers-npc/organization/bupers/WomensPoli cy/Documents/2012_Pregnancy_and_Parenthood_Executive_Summary.pdf. Published September, 2014. Accessed February 11, 2014.

2. RTI International. 2008 Department of Defense survey of health related behaviors among active duty military personnel. TRICARE Management Activity. http://www.tricare.mil/tma/2008HealthBehaviors.pdf. Published September 2009. Accessed February 26, 2013.

3. Office of the Chief of Naval Operations. OPNAV Instruction 6000.1C.Navy Personnel Command. http://www.med.navy.mil/directives/oth/OPNAV%206000.1C.pdf. Retrieved February 19, 2013.

4. Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion. Contraception. Center for Disease Control and Prevention.