Exploring Women’s Experiences with Long-Acting Reversible Contraception: A Multi-Methods Qualitative Study In Ontario

Abstract

Use of long-acting reversible contraception (LARC) is a highly effective strategy for preventing pregnancy. Methods of LARC include the intrauterine device (IUD) and the contraceptive implant; the latter is currently unavailable in Canada. Less than 5% of Canadian women use LARC as their contraceptive method. Exploration of women’s experiences with methods of LARC can shed light on the factors and dynamics influencing information and use. Understanding these dynamics may also inform efforts to increase awareness of the contraceptive implant, once it is approved for use in Canada. This multi-methods study aimed to assess Ontario women’s knowledge of and attitudes toward methods of LARC and identify avenues to improve information and services related to LARC in the province. The study comprises two components: an anonymous online bilingual survey and a telephone/Skype interview with a subset of survey participants. Our results suggest that the main factors influencing LARC use are its ease of use, efficacy, and recommendation by a health care professional. Most survey respondents were satisfied with the information provided by their health care provider when they were first prescribed LARC. However, Franco-Ontarian participants we interviewed faced challenges obtaining reproductive service in French. Participants highlighted a number of ways that LARC could be improved and new methods of LARC could be introduced in Canada. This study provides insight into opportunities to improve counselling to Ontarian women and highlights areas that should be routinely discussed with contraceptive patients about methods of LARC.