LARC Toolkit: Increasing Access to LARC Through Innovative Clinical Pathway

All people should have access to the full range of contraceptive options in order to ensure they are able to select and access the method that is right for them, as well as be able to stop or change that method at any time. Achieving full contraceptive choice is an important step towards ensuring that all people have the ability to choose if, when, and how to start and grow a family, but many challenges must be addressed before this vision can be fully realized. Access to long-acting reversible contraception (LARC), and to LARC removal, is one such challenge. LARC access is often impacted by a range of administrative, regulatory, and systems-level barriers. At the same time, great strides have been made in recent years by a range of local, state, and national stakeholders to address those barriers. NIRH seeks to continue to contribute to this important work by partnering with organizations on the ground in support of initiatives to address these challenges.

NIRH is committed to partnering with organizations to remove barriers to contraceptive access using a framework that centers around patient autonomy and choice. Although public health officials in some areas have encouraged LARC use, they have frequently targeted their efforts at marginalized communities and particularly women of color, who have historically experienced many forms of reproductive oppression, including forced sterilization, and may view such programs with warranted distrust. To ensure reproductive freedom, it is important that reproductive coercion in any form be eliminated, and every person must instead be provided with comprehensive, scientifically accurate information about the full range of contraceptive options in a medically ethical and culturally competent manner.

This toolkit is based on NIRH’s partnership with Planned Parenthood League of Massachusetts and Brigham & Women’s Hospital as part of the 2016 LARC Access Project and intended to support organizations interested in replicating this work.

“Increasing Access to LARC through the Development of an Innovative Clinical Pathway” provides guidance for health care providers and staff on how to increase access to long-acting reversible contraception (LARC) by establishing an effective referral pathway from primary care providers who are not trained in LARC insertion to providers who do have such training. It also establishes a framework for evaluating a high-quality LARC referral and includes a range of suggested interventions to improve LARC referrals. This toolkit is based on NIRH’s partnership with Brigham & Women’s Hospital as part of the 2016 LARC Access Project.