Birth control in focus

Women’s reproductive health has been a hot topic since the November election and Republicans’ promises to repeal the Affordable Care Act, which provides no-cost birth control.

The uncertainty has sent women in the region to Planned Parenthood for long-acting reversible contraceptives in droves.

Since the election, Planned Parenthood Columbia Willamette has seen an “unprecedented surge” in questions about birth control coverage and health care access, said spokesman Jimmy Radosta. Demand for intrauterine devices increased more than 900 percent following the election, he said.

Planned Parenthood’s Vancouver Health Center saw an increase, too. Demand for IUDs and birth control implants increased 34 percent in the four months after Election Day, according to Planned Parenthood.

While The Vancouver Clinic’s data doesn’t show an increase in the number of people interested in long-acting reversible contraceptives, or LARCs, midwife Kate Fields said she’s had more patients cite uncertainty about their health coverage as the reason for seeking the birth control when they did.

“People will say, ‘I’m worried my health insurance will go away, and I won’t be able to get my pills’ or ‘I don’t want to worry about it in case my insurance goes away,’ ” Fields said. “When you go beyond the numbers, I think it’s bringing people in because they’re scared.”

And when women come to Fields to learn about their birth control options, LARCs are the first-line therapy.

“If somebody comes to me to talk about birth control, that’s where I start,” Fields said.

IUDs gain ground

There are two types of LARCs: intrauterine devices and implants. And, lately, IUDs have been growing in popularity.

“More people recently have come in specifically asking about IUDs,” Fields said.

An IUD is a small T-shaped device inserted into the uterus. The device must be inserted and removed by a medical provider.

The Mirena IUD is plastic and uses the hormone progestin to prevent pregnancy. It’s effective for five years. A copper IUD, named ParaGard, is also available and doesn’t use hormones. That device is effective for 10 years.

In recent years, smaller IUDs have hit the market, as well. The smaller IUDs — named Skyla and Kyleena — are designed specifically for women who have never given birth. The Skyla is only effective for three years. The Kyleena, which was recently approved by the Food and Drug Administration, is effective for five years.

The other type of LARC, the implant, is a flexible, matchstick-sized rod that uses synthetic progesterone to prevent pregnancy. The rod is implanted in the upper arm and is effective for three years.

The hormones in the plastic IUDs and the implant, named Nexplanon, prevent ovulation. They also thicken the cervical mucus to prevent the sperm from meeting the egg, Fields said. The LARCs use a smaller amount of hormones compared with other methods, such as birth control pills and rings, she said. The copper IUD prevents pregnancy because the copper is toxic to sperm.

The IUDs and implants are more than 99 percent effective — making them as effective as surgical sterilization.

Unlike other methods of birth control, their effectiveness doesn’t rely on user compliance. Birth control pills, for example, are 99 percent effective when used perfectly. With their typical use, however, they’re 91 percent effective at preventing pregnancy, Fields said.

“This is why these are so good for teenagers,” Fields said. “With the IUD, you don’t have to be perfect. It’s doing the work for you.”

IUDs are popular among teens and women in their 20s, as well as new moms, Fields said.

“The thing with the IUD and planning pregnancies, they work really well,” she said.

IUDs and implants are completely reversible and don’t delay fertility, Fields said. As soon as they’re removed, the woman goes back to her baseline fertility, she said.

“Women should really think about these methods,” Fields said. “They’re just so much better than the pill.”