The magic of LARCs

Last weekend I taught a pregnancy options counseling training for nurses at the New York City Health Department – a program called Connecting Adolescents to Comprehensive Health (CATCH). The program generally and the specific nurses and health educators who I met just impressed the pants off of me. The program is entirely data driven – and they’re getting results. If I were talking with my grandmother, I might even be inclined to say they were getting results like the dickens!

The secrets to some of the CATCH program’s successful statistics are referrals to Long Acting Reversible Contraceptives (LARCs). While this hardly feels like a secret, the other things that they’re doing right include meeting the students where they are (both physically, in schools, and emotionally, without judgment). This is not possible in Texas – where a teacher can get fired for giving a student a condom.

And so, this week, in honor of the CATCH program and in honor of the incredible impact that LARCs are having on women’s capacity to make informed choices about their reproduction, we’re going to focus on LARCs. Somewhat embarrassingly, but out of logistical necessity, we’re going to start this week with one of my very own lesson plans from Positive Images:

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INTRODUCING LARCS

By Karen Rayne, PhD

Objectives

By the end of this lesson, participants will be able to:

1. Name the three long-active reversible contraceptives (LARCs).

2. Identify how long each LARC provides contraceptive protection.

3. List the function of LARCs in general and for each specific LARC.

Rationale

As young people begin to have sexual intercourse, it is important for them to learn about the contraceptive options available to them and the ways they work so that they can make informed decisions about their sexual health. Long-acting reversible contraceptives (LARCs) are highly effective. They are far more effective than short-term reversible contraceptive such as the Pill, the ring, the patch and condoms. Because they are highly effective, LARCs should be considered a viable alternative to short-term contraceptives. This lesson provides participants with the information required to make a decision about whether LARCs are appropriate for them or their partners.

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It seems oh-so-slightly-disingenuous to go on and on about how fantastic my lesson plan is, so instead I want to focus on the fantastic nature of LARCs.

Imagine this:

You’re in bed, slowly waking up, when you suddenly realize it’s far lighter in the room than it should be at wake up time. Either the alarm didn’t go off or you turned it off in your sleep like usual. You jump out of bed, pick up the top pair of pants and shirt in your closet, throw them on as you run through the kitchen to grab a banana and your purse and then out the door, late. Again.

Now imagine that you’re on the Pill, a short-term contraceptive, and you’ve just forgotten it. You’ve opened up a tiny gap in your hormonal dosage that could lead to a pregnancy.

Or, imagine that you’re on a LARC. Nothing about what happened there introduces any kind of gap in the hormonal dosage or your contraception.

LARCs offer contraceptive support through the daily insanity that comes with being human. Sometimes I wish there could be a LARC for other things – like tooth brushing, so it would be no big deal if I forgot that sometimes. Sadly, there is not. But we should encourage sexually active women and teenagers who are looking for a contraceptive to consider LARCs and whether they’re right for them. This lesson does a fantastic job of doing just that. (Okay, maybe a little tiny bit of telling you how great my own lesson plan is…)