August 31, 2026

The Society of Family Planning issued first-of-its-kind clinical guidance that bridges a critical gap in contraceptive care for complex cases when contraceptive implants cannot be removed using standard techniques. This Committee Statement, Management of deep and nonpalpable contraceptive implants, is endorsed by the North American Society for Pediatric and Adolescent Gynecology and Planned Parenthood Federation of America and published in Contraception.

Contraceptive implants are highly effective, long-acting reversible contraceptive rods placed under the skin of the upper arm. While most implants are easily removed by a trained clinician during a routine office visit, in rare cases, an implant may be placed incorrectly or migrate significantly, making it difficult to locate and remove.

The Society convened national experts to develop the first evidence-informed, person-centered recommendations to address outpatient identification, localization, removal and management of complications, advising that clinicians avoid unnecessarily invasive surgical procedures or improper removal attempts

To increase access to prompt referrals to clinicians who specialize in advanced removal techniques, the Society launched the first public national directory of Contraceptive Implant Centers of Experience (COEs). The COE directory connects clinicians and implant users with a network of more than 180 clinicians across 38 states and Washington, DC who specialize in removing deep, complex and nonpalpable contraceptive implants.

“Advancing just and equitable healthcare requires pairing rigorously developed guidance with sustained attention to how care is delivered in practice,” said Amanda Dennis, DrPH, MBE, President of the Society of Family Planning. “The Society convened leading experts to address the gap in clinical guidance on complex contraceptive implant removal, while actively leveraging our clinician network to build seamless referral pathways.” 

The Society’s Committee Statement was developed with the leadership of complex family planning subspecialists who bring advanced training in care for individuals with medically complex contraceptive needs. Subspecialists contributed to the Society’s efforts as both authors of the clinical guidance and Steering Panel members of the Society’s COE initiative, which sets standards and qualifications for clinicians to become a COE and maintains a directory of all the COEs in the US.

“Most deep or nonpalpable contraceptive implant removals can occur in an outpatient setting, but awareness, clinical recommendations, and referral opportunities have been limited,” said Paula Castaño, MD, MPH, lead author of the Committee Statement, COE Steering Panel member, and associate professor of obstetrics and gynecology at Columbia University Vagelos College of Physicians and Surgeons. “This guidance, combined with a growing, publicly available network of referrals, seeks to advance equitable access to timely contraceptive discontinuation by preventing delays in care, unsuccessful removal attempts and referrals for unnecessary surgery.”

Management of deep and nonpalpable contraceptive implants is published in Contraception. Read more about the Society’s approach to clinical guidance.

The Society of Family Planning is an academic society of more than 1,900 clinicians, scholars, and partners who are dedicated to just and equitable abortion and contraception informed by science. Leveraging the tools of science and medicine, and working in partnership with our broad community, the Society supports evidence-informed and person-centered healthcare.