Reframing “success” in person-centered contraceptive access: Situating LARC in the contraceptive journey
Contraception
Awarded 2025
Exploring patterns of LARC use through mixed methods research
Ariana Bennett, DrPH, MPH
University of California, Berkeley
$125,000

“Success” in long-acting reversible contraceptive (LARC) use, such as IUDs and implants, is generally understood as method initiation and use for the duration of the device. Increasingly, research and advocacy efforts have problematized approaches that prioritize LARC promotion over reproductive autonomy, calling attention to biased practices that undermine reproductive self-determination, particularly for groups subjected to historic and ongoing reproductive oppression. Despite these critiques, existing measures of success around LARC remain narrow, have not been defined by people themselves, and neglect the historical context of coercive LARC promotion and the complex decision-making processes around LARC use. This study aims to fill these gaps by identifying aspects and trajectories of LARC use that users themselves define as successful as they choose, use, and discontinue LARCs over their life course. We will use an explanatory sequential mixed methods design, in which quantitative data is analyzed first and used to inform the qualitative study design. We will leverage secondary nationally representative survey data to quantitatively identify patterns of LARC use and how they relate to indicators of “success.” We will then expand on those insights through a qualitative interview study focused on current and former LARC users from groups that have been historically subjected to coercive LARC practices. We will use journey mapping to explore how LARC has fit into their reproductive life course, with a focus on their experiences of success and challenges. Results from this study that provide alternative, person-centered constructs of “success” can be used to improve clinical care, research, and discourse around LARC.