Identifying Trends and Barriers to Long-acting Reversible Contraceptive (LARC) Use in Ethnic Minority Women


Despite the range of contraceptive options available, 49% of all pregnancies in the US are unintended. Rates of unintended pregnancy, unintended births, short inter-pregnancy intervals and abortion occur more often among minority and low socioeconomic status women and are associated with adverse maternal and infant outcomes. In New Mexico, 39% of pregnancies were unintended in non-Hispanic white women compared to 50% in Native American women and 46% in Hispanic women. Hispanic teens have the highest birth rates both in New Mexico, accounting for 70% of the births to young teens.

Long-acting reversible contraceptives—intrauterine devices and the contraceptive implant—show great promise in reducing the high rates of unintended pregnancy and abortion in the US. Ethnic minority women, including immigrants, experience many barriers to accessing effective contraceptive methods and to using methods consistently.

  • Cultural differences in approaches to contraception
  • Language barriers
  • Lack of health care coverage
  • Differences in provider behavior based on women’s race/ethnicity.

Our Project

The primary objective of our project is to determine whether the uptake of postpartum LARC methods differs between ethnic minority women and non-Hispanic white women. We studying postpartum women because they are particularly motivated to use contraception and usually choose and/or initiate a method prior to hospital discharge. Furthermore we hope to identify reasons for non-use and barriers to obtaining the desired LARC methods and determine if these differ by ethnicity.


This study will serve as a pilot project to determine if the uptake of LARC methods varies by ethnicity. In addition, we seek to identify reasons for non-use and barriers to obtaining the desired LARC method. This work will serve as the basis for designing specific postpartum interventions to reduce barriers to accessing LARC methods by all women. Our specific aims are to determine if the uptake of LARC methods differs between non-Hispanic white women and ethnic minority by 16 weeks postpartum and to identify specific reasons, by ethnicity, for not receiving the intended LARC contraceptive method postpartum.

  • Postpartum women who plan to use a LARC method before discharge from the hospital or who plan to get a LARC method at their postpartum visit will be enrolled/consented and complete a questionnaire about contraceptive choice and access to services.
  • A follow-up phone call at 10 weeks (with contact made no later than 16 weeks) will be made to administer a second questionnaire to determine whether the intended contraceptive method was obtained, and whether barriers were encountered to receiving the intended method. Additional questions will identify alternative methods used, pregnancy, and health care access status.
  • Review of electronic medical records for patients receiving care in the UNM system will also be used.

Data showing that the uptake of LARC methods differs by ethnicity in postpartum women and furthermore that this difference is due to barriers will help inform the design and implementation of interventions to help reduce these disparities.