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Unintended Pregnancy and Long-Acting Reversible Contraceptives

June 29, 2021
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WRITTEN BY Dr. Josh Mueller and Dr. Jill Barnas

In contrast to oral contraceptives or sterilization, long-acting reversible contraceptives (LARCs) are a form of birth control that prevent pregnancy for long durations after application (months to years), but whose use can be discontinued at any point without affecting fertility. LARCs include intrauterine devices (IUDs), subdermal implants, and injectable contraceptives. LARC methods are the most effective forms of reversible contraception, with a failure rate less than 1%. Several programs and policies have demonstrated that increasing the availability of LARCs decreases the number of unintended pregnancies and abortions, and saves costs associated with unintended pregnancy.


  • An estimated 45% of pregnancies in the United States are unintended, with higher rates for adolescents, low-income women, and women without insurance. Unintended pregnancies have been tied to negative social, economic, and health consequences for parents and children.
  • State-level policies that increase access to LARCs have been shown to increase LARC use and decrease teen birth rates, which are often a proxy for unintended pregnancies.
  • Programs in St. Louis and Colorado have also demonstrated that providing access to LARCs can reduce unintended pregnancy rates, teen birth rates, and abortion rates.


  • Only a few long-term studies of negative outcomes for children conceived unintentionally have been performed in the United States. The results from these studies are observational, meaning that it is difficult to confidently assign the cause of these outcomes to unintentional pregnancy alone.
  • There is currently a lack of data on LARC use in Missouri, so it is difficult to assess how the state compares in terms of access and uptake.
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