Long-acting reversible contraception and the coming Trump presidency

The results of the 2016 presidential election have led to many discussions on a wide range of topics, and one of them has been focused on healthcare. Specifically, will a Trump presidency mean an end to the Affordable Care Act (ACA), the federal healthcare bill that was signed into law under President Obama in 2010? 

Why are we talking about this on Bundoo, a pregnancy and parenting site? Well, one major part of the ACA revolves around contraception. That is, FDA-approved methods of birth control are currently covered under the ACA. This means that certain forms of birth control that used to be far too expensive for many women are now attainable by many who previously couldn’t afford them.

In the days after the election, you may have heard from your friends or seen on social media advice to go get your IUD or Nexplanon now, before the ACA is repealed or dismantled. This was specifically in response to the concern that coverage for birth control may be a thing of the past.

What is so special about IUDs and Nexplanon? These are two types of birth control known as long-acting, reversible contraception, or LARCs. They are forms of birth control that work for a long time (from 3 to 10 years depending on the type of LARC used) but are completely reversible. This means that once they are removed, you are fertile and can get pregnant again.

Their benefit? They work amazingly well (they only fail less than 1 percent of the time!) since they don’t require you to do anything every day, unlike a pill that you may forget to take. They also allow your fertility to return immediately, so they are great for women who want an excellent form of birth control when they need it, but who want to be able to try to conceive once they are done using the LARC. Most LARCs also greatly decrease your period or make them go away completely (the only one that doesn’t work like this is the copper IUD known as the Paragard … heavier periods are the norm for this LARC).

LARCs are not perfect, however. They do require an office procedure to have them placed, which while short — usually taking a few minutes or less — can be briefly uncomfortable for patients. And up until the ACA, they were very expensive, costing up to $1,000 for some women. Certain side effects and complications may occur, but these are much rarer than any complications associated with pregnancy and often completely treatable.

In 2012, 11.5 percent of all women in the United States using birth control are using a LARC. This number was only 2.5 percent in just 2002, and the decreased cost since the ACA went into effect may be part of this jump. This trend will probably continue as long as LARCs continue to be affordable under the ACA.

You might wonder who is a candidate for using a LARC, and the answer is great: almost all women! They are safe for use in women who’ve had babies before, women who’ve never had babies, teenagers, women with multiple sexual partners, and women who want to have babies in the future. Many LARC myths exist, but you can get the facts here.

So, should you call your OBGYN or midwife and get your IUD or Nexplanon before Trump takes the presidential oath? Well, you should not just rush to get one if you don’t really want it. And the likelihood that the ACA will be dismantled the day Trump takes office is rather slim. Restrictions on birth control may go into effect and this coverage may not be guaranteed forever under his administration, though, so if you were already considering one or are now after what you’ve read here, there’s no time like the present to make an appointment to discuss your options.

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