Contraceptive access and use of long-acting reversible contraceptives during the COVID-19 pandemic and beyond

Changes in access to healthcare services during the COVID-19 pandemic may have impacted individuals' access to contraceptive care, including long-acting reversible contraceptives (LARCs), which require ⩾1 visit for insertion and/or removal.

This study aimed to describe the utilization and accessibility of contraceptive services and contraceptive methods, including LARCs, during the COVID-19 pandemic and understand individuals' preferred approaches for accessing contraceptive care and prescriptions in the future.

Cross-sectional study.

Quantitative data were collected from US individuals assigned females at birth at risk for pregnancy and seeking contraceptive methods for pregnancy prevention (aged 18-49 years) via an online survey fielded in 2022. Measures included: contraceptive methods used pre-pandemic, during the pandemic, current, and planned for the future; the impact of the pandemic on LARC insertions/removals; site of care for contraceptive counseling, prescribing, and filling across time periods.

Analyses included 1878 respondents; mean age = 30.8 years, 86.2% cisgender female; 64.5% non-Hispanic White. The most common forms of contraception used by respondents pre-pandemic, during, and currently were the pill (31.0% (95% confidence interval (CI): 29.0%-33.2%), 31.3% (29.2%-33.4%), 28.3% (26.3%-30.4%)), male condom (10.9% (9.5%-12.3%), 12.8% (11.4%-14.4%), 13.7% (12.2%-15.3%)), intrauterine device (IUD) (8.5% (7.3%-9.8%), 9.6% (8.3%-11.0%), 10.2% (8.9%-11.6%)), implant (4.9% (4.0%-5.9%), 4.2% (3.4%-5.2%), 4.6% (3.8%-5.7%)), shot (4.8% (3.9%-5.9%), 4.3% (3.5%-5.3%), 4.0% (3.2%-5.0%)), and withdrawal (3.9% (3.1%-4.9%), 4.2% (3.4%-5.2%), 6.0% (5.0%-7.1%)), respectively. The use of these methods was consistent across time periods. Of respondents who wanted a LARC inserted (n = 446) or removed (n = 104) during the pandemic, 38.3% and 37.5%, respectively, reported their insertion/removal was impacted by the pandemic (e.g., delayed, went to a different office, used a different healthcare provider). The proportion of respondents who planned to use in-person-only services for contraceptive care and remote-only services for filling prescriptions in the future was higher than before and during the pandemic.

Despite the consistency in the contraceptive methods used across time periods, the COVID-19 pandemic affected the way in which individuals received contraceptive services, particularly those seeking LARC services, which require in-person visits for insertion and removal. As we move out of the pandemic, special care should be paid to ensuring prompt access to individuals' preferred choice of contraceptive services.