NCHS Data Brief ■ No. 188 ■ February 2015

u.s. department of health and human services

Centers for Disease Control and Prevention

National Center for Health Statistics

Trends in Long-acting Reversible Contraception 

Use Among U.S. Women Aged 15–44
 

Amy M. Branum, M.S.P.H., Ph.D.; and Jo Jones, Ph.D. 

Key findings 

Data from the National 

Survey of Family Growth 

● Use of long-acting reversible 

contraceptives (LARCs) declined 

between 1982 and 1988, 

remained stable through 2002, 

and then increased nearly fivefold in the last decade among 

women aged 15–44, from 1.5% 

in 2002 to 7.2% in 2011–2013. 

● The percentage of women 

using LARCs has remained 

highest among women aged 

25–34, with more than twice 

as many women aged 25–34 

(11.1%) using LARCs in 

2011–2013 compared with 

women aged 15–24 (5.0%) and 

aged 35–44 (5.3%). 

● After decreasing between 

1982 and 1988 and remaining 

stable from 1988 through 1995, 

LARC-use patterns diverged 

among Hispanic, non-Hispanic 

white, and non-Hispanic black 

women. 

● Women who have had at least 

one birth use LARCs at a higher 

rate compared with women who 

have had no previous births, and 

this difference has increased over 

time. 

Long-acting reversible contraceptives (LARCs), which include intrauterine 

devices (IUDs) and subdermal hormonal implants, are gaining popularity due 

to their high efficacy in preventing unintended pregnancies. IUD use was more 

common among U.S. women in the 1970s before concerns over safety led to a 

decline in use (1); however, since approval of a 5-year contraceptive implant 

in 1990 and redesigned IUDs, there has been growing interest in the use of 

LARCs for unintended pregnancy prevention. Using data from the 1982, 1988, 

1995, 2002, 2006–2010, and 2011–2013 National Survey of Family Growth 

(NSFG), this report examines trends in current LARC use among women aged 

15–44 and describes patterns of use by age, race and Hispanic origin, and 

parity. 

Keywords: intrauterine devices • hormonal implants • National Survey of 

Family Growth 

Current use of a long-acting reversible contraceptive method 

increased nearly five-fold in the last decade among women 

aged 15–44. 

Figure 1. Trends in current long-acting reversible contraceptive use, by device 

1

Implants were not available in 1982 and 1988. 

NOTES: Linear decrease from 1982 to 1988 and linear increase from 2002 to 2011–2013 for all LARCs are statistically 

significant; linear increase in IUD use from 1995 to 2011–2013 is statistically significant. IUD is intrauterine device; LARCs are 

long-acting reversible contraceptives. 

SOURCE: CDC/NCHS, National Survey of Family Growth, 1982, 1988, 1995, 2002, 2006–2010, and 2011–2013. Percent 

0 

2 

4 

6 

8 

10 

12 

2011– 

2013 

2006– 

2010 

1995 2002 11988 11982 

LARCs IUD Implant
NCHS Data Brief ■ No. 188 ■ February 2015

●		 In 1982, 4.0% of women aged 15–44 reported using a LARC for their current contraceptive 

method; by 1988, current LARC use was reported by 1.4% of women (Figure 1). 

●		 After no change between 1988 and 2002, current LARC use doubled between 2002 (1.5%) 

and 2006–2010 (3.8%) and then nearly doubled for 2011–2013 (7.2%). 

●		 IUDs have accounted for the largest proportion of LARC usage since 2002. Comparing 

2006–2010 with 2011–2013, IUD use increased 83% (from 3.5% to 6.4%), while implant 

use tripled (from 0.3% to 0.8%). 

In 1982 and since 2002, women aged 25–34 used long-acting reversible 

contraception at a higher rate compared with women aged 15–24 or 33–44. 

●		 Current LARC use was higher among women aged 25–34 compared with women aged 

15–24 at all time points except 1988 and 1995. Although LARC use tended to be higher 

among women aged 25–34 compared with women aged 35–44, the difference was not 

always statistically significant (Figure 2). 

●		 After remaining relatively unchanged from 1982 to 2002, LARC use among women aged 

15–24 increased nearly four-fold between 2002 (0.6%) and 2006–2010 (2.3%) and doubled 

again for 2011–2013 (5.0%). 

Figure 2. Trends in long-acting reversible contraceptive use, by age 

15–24 25–34 35–44 12 

11.1 

10 

8 

Percent

6.5 

6 

5.3 1

5.3 1

5.0 

1

4.2 

4 3.8 

2.9 

1

2.3 2.1 

2 1.7 1

1.4 1.4 1.5 1

1.1 0.9 1

0.6 

* 

0 

1982 1988 1995 2002	 2006– 2011– 

2010 2013 

1

Significantly less than women aged 25–34. 

* Figure does not meet standards of reliability or precision; too few women aged 15–24 reported using long-acting reversible contraceptives in 1988. 

NOTE: Linear trends in use of long-acting reversible contraceptives for all age groups from 2002 to 2011–2013 are statistically significant. 

SOURCE: CDC/NCHS, National Survey of Family Growth, 1982, 1988, 1995, 2002, 2006–2010, and 2011–2013. 

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NCHS Data Brief ■ No. 188 ■ February 2015

●		 From 2006–2010 to 2011–2013, LARC use approximately doubled among women aged 

25–34 (5.3 to 11.1%). 

●		 After tripling between 2002 (1.1%) and 2006–2010 (3.8%), LARC use slowed among 

women aged 35–44, to a 34% increase from 2006–2010 to 2011–2013 (5.3%). 

Patterns of use of long-acting reversible contraception varied by race and 

Hispanic origin over the last 30 years. 

●		 Decreases in LARC use were similar for Hispanic, non-Hispanic white, and non-Hispanic 

black women from 1982 to 1988 and remained stable for each race and Hispanic origin 

group from 1988 to 1995. However, after 1995, patterns of use diverged (Figure 3). 

●		 Although LARC use tripled for non-Hispanic white women and increased four-fold for 

non-Hispanic black women between 2002 and 2006–2010, use among Hispanic women 

declined 10% during this period. 

●		 LARC use increased at a similar rate among Hispanic (129%) and non-Hispanic white 

(128%) women from 2006–2010 to 2011–2013, whereas non-Hispanic black women had a 

30% increase in LARC use during this time. 

Figure 3. Trends in long-acting reversible contraceptive use, by race and Hispanic origin 

1

Significantly significantly less than Hispanic women. 

NOTES: Linear trends for non-Hispanic white and non-Hispanic black women from 2002 through 2011–2013 are statistically significant. 

SOURCE: CDC/NCHS, National Survey of Family Growth, 1982, 1988, 1995, 2002, 2006–2010, and 2011–2013. Percent

1 

1 

1 1 

1 

0 

2 

4 

6 

8 

10 

12 

Non-Hispanic black 

Non-Hispanic white 

Hispanic 

2011– 

2013 

2006– 

2010 

1982 1988 1995 2002

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NCHS Data Brief ■ No. 188 ■ February 2015

Women who have had at least one birth use LARC methods at a higher rate 

than women who have had no previous births. 

●		 In 1982, parous women (6.0%) used LARCs five times more often compared with 

nulliparous women (1.2%); during 2011–2013, rate of use was three times greater among 

parous (11.0%) compared with nulliparous (2.8%) women (Figure 4). 

●		 After remaining stable between 1988 and 2006–2010, LARC use increased almost 10-fold 

among women with no previous births through the 2011–2013 time period. 

●		 Among parous women, LARC use declined between 1982 and 1988 and remained stable 

until 2002, when it increased two and one-half times between 2002 (2.4%) and 2006–2010 

(6.3%), and then increased nearly 70% from 2006–2010 to 2011–2013 (10.6%). 

Figure 4. Trends in long-acting reversible contraceptive use, by parity Percent 

0 

2 

4 

6 

8 

10 

12 

Parous 

Nulliparous 

2011– 

2013 

2006– 

2010 

1982 1988 1995 2002

NOTES: Linear decrease in use of long-acting reversible contraceptives (LARCs) from 1982 to 1988 is statistically significant for parous women only. Linear 


increase in LARC use for both parity groups from 2002 through 2011–2013 is statistically significant. Nulliparous women had statistically significantly lower 


LARC use compared with parous women for each time point.
 

SOURCE: CDC/NCHS, National Survey of Family Growth, 1982, 1988, 1995, 2002, 2006–2010, and 2011–2013.
 

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NCHS Data Brief ■ No. 188 ■ February 2015

Summary 

After declining from the early 1980s through 2002, use of long-acting reversible contraception 

has increased over the last decade. Women aged 25–34 and women who have already had a child 

continue to use LARCs at the highest rates as their current contraceptive methods; additionally, 

larger percent increases in LARC use have occurred more recently among young women (aged 

15–24) and women who have not given birth. Although sharp increases in use occurred among 

non-Hispanic black women between 2002 and 2006–2010, the rate of increase has slowed 

through the 2011–2013 time period. LARC use more than doubled among Hispanic and nonHispanic white women in the most recent time periods. Non-Hispanic white women, who have 

historically used LARCs at the lowest rate, had a rate of use similar to Hispanic women in 

2011–2013. 

Long-acting reversible contraception has demonstrated greater efficacy in preventing unintended 

pregnancy among all women compared with other contraceptive methods, including the oral 

contraceptive pill and the transdermal patch (2,3). In addition, recent research has demonstrated 

that women opt for long-acting methods as their contraceptive method of choice when informed 

about these options (4); however, other research has demonstrated that barriers to LARC 

administration and use still remain (5,6). 

Definitions 

Contraceptive status: This variable measures the contraceptive method used (if any) in the month 

of the interview. The recode variable used was CONSTAT1. In this report, women who were 

currently using more than one method were classified by the method that was most effective in 

preventing pregnancy, because that method has the greatest impact on their risk of unintended 

pregnancy. For example, women who reported using both LARCs and male condoms in the 

current month were classified as using LARCs because LARCs are more effective in preventing 

a pregnancy. In 2011–2013, 10.7% of women who were currently using contraception used more 

than one contraceptive method during the same month. 

Hispanic origin and race: The Office of Management and Budget (OMB) guidelines for the 

presentation of race and origin data in federal statistics are used for these classifications (7). The 

1997 OMB guidelines where each respondent may choose more than one race are followed, and 

the recode variable, HISPRACE2, is used for the 2002, 2006–2010, and 2011–2013 survey 

years. For the 1982, 1988, and 1995 survey years, an equivalent of HISPRACE2 was constructed 

by restricting the analysis to women who only reported one race. In this report, the categories 

Hispanic, non-Hispanic white single race, and non-Hispanic black single race are shown. Given 

the diversity of women categorized as non-Hispanic other single and multiple race, those results 

are not shown. 

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NCHS Data Brief ■ No. 188 ■ February 2015

Data source and methods 

This report is based on data from women in the female respondent files of the 1982, 1988, 1995, 

2002, 2006–2010, and 2011–2013 NSFG. The data are comparable across the years included for 

this analysis on the key variables shown in this data brief. The 1982 survey served as the starting 

point, as NSFG in years prior to 1982 was conducted only among women who were currently or 

formerly married; therefore, the data for these years are not comparable to data in the 1982 NSFG 

and beyond for purposes of this analysis. 

Among other information, NSFG provides detailed information about contraceptive use among 

U.S. women of reproductive age. NSFG is jointly planned and funded by the Centers for Disease 

Control and Prevention’s National Center for Health Statistics and several other programs of the 

U.S. Department of Health and Human Services. All estimates in this report were weighted to 

reflect the reproductive-aged female household population of the United States of the midpoint 

for each time period of the survey. 

Statistics for this report were produced using the SURVEY procedures in SAS software version 

9.3. Differences between percentages were evaluated using two-tailed significance tests at the 

0.05 level. The significance of trends was tested using weighted least-squares regression models 

to determine whether an apparent change over time was statistically significant, taking into 

account the standard error for each data point. The data presented in this report are bivariate 

associations that may be explained by other factors not controlled for in the figures or included in 

the report. 

About the authors 

Amy M. Branum and Jo Jones are with CDC’s National Center for Health Statistics, Division of 

Vital Statistics, Reproductive Statistics Branch. 

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NCHS Data Brief ■ No. 188 ■ February 2015

 

References 

1.		 Cleland K, Zhu H, Goldstuck N, Cheng L, Trussell J. The efficacy of intrauterine devices 

for emergency contraception: A systematic review of 35 years of experience. Hum Reprod 

27(7):1994–2000. 2012. 

2.		 Winner B, Peipert JF, Zhao Q, Buckel C, Madden T, Allsworth JE, Secura GM. 

Effectiveness of long-acting reversible contraception. N Eng J Med 366(21):1998–2007. 2012. 

3.		 CDC. U.S. medical eligibility criteria for contraceptive use, 2010. MMWR 59(RR-4):1–86. 

2010. 

4.		 Secura GM, Madden T, McNicholas C, Mullersman J, Buckel CM, Zhao 

Q, Peipert JF. Provision of no-cost, long-acting contraception and teenage pregnancy. N Engl J 

Med 371(14):1316–23. 2014. 

5.		 Park HY, Rodriguez MR, Huelett D, Darney PD, Thiel de Bocanegra H. Long-acting 

reversible contraception method use among Title X providers and non-Title X 

providers in California. Contraception 86(5):557–61. 2012. 

6.		 Beeson T, Wood S, Bruen B, Goldberg DG, Mead H, Rosenbaum S. Accessibility of 

long- acting reversible contraceptives (LARCs) in federally qualified health centers (FQHCs). 

Contraception 89(2):91–6. 2014. 

7.		 OMB. Race and ethnic standards for federal statistics and administrative reporting. Directive 

no. 15. Adopted May 12, 1977. Available from: http://wonder.cdc.gov/wonder/help/ 

populations/bridged-race/directive15.html. 

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NCHS Data Brief ■ No. 188 ■ February 2015

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Suggested citation 

Branum AM, Jones J. Trends in long-acting 

reversible contraception use among U.S. 

women aged 15–44. NCHS data brief, no 

188. Hyattsville, MD: National Center for 

Health Statistics. 2015. 

Copyright information 

All material appearing in this report is in 

the public domain and may be reproduced 

or copied without permission; citation as to 

source, however, is appreciated. 

National Center for Health 

Statistics 

Charles J. Rothwell, M.S., M.B.A., Director 

Nathaniel Schenker, Ph.D., Deputy Director 

Jennifer H. Madans, Ph.D., Associate 

Director for Science 

Division of Vital Statistics 

Delton Atkinson, M.P.H, M.P.H, P.M.P, 

Director 

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