LARC, every woman’s right

International Women’s Day (IWD) is celebrated annually on March 8 throughout the world. The purpose is to honor women’s achievements throughout history and across nations. Although the beginnings of this celebration occurred among women’s groups over a hundred years ago, it was officially adopted by the United Nations in 1996. Each year since, the UN proclaims the official theme for IWD. For 2017 the theme is “Be Bold for Change”. I was struck by the strength of its charge. Be bold! My mother always cautioned me not to be bold. But times are different now and she is no longer here.   

 In the United States, the status of women has improved significantly because of their access to contraception and abortion. But that access is being threatened by the current confusion over the definition of ‘birth control”, which includes both contraception (preventing conception) and abortion. Those opposed to abortion are usually not opposed to contraception. But they are opposed to “birth control,” which is interpreted as a euphemism for abortion. I am suggesting that we clarify the difference so that safe and effective contraception is easily available for all women of reproductive age who do not want to get pregnant. This will greatly reduce the need for abortions. We must reduce the rate of unplanned pregnancies in order to reduce the abortion rate. Presently, 49% of pregnancies in the United States are unplanned. 

Here is my bold recommendation: All women of reproductive age who do not want to get pregnant should have access to a LARC, a Long-Acting Reversible Contraceptive. This includes IUDs, injections, and implants which are safe and almost 100% effective in preventing pregnancy. Oral contraceptives, condoms, and diaphragms have much lower pregnancy prevention effectiveness rates. LARCs are more costly than condoms or pills in the short term, but their superior effectiveness in the prevention of unplanned pregnancies makes them more cost-effective long term. 

The United States is in the midst of a heroin/opioid epidemic. The number of drug-addicted babies being born has quadrupled in just one decade. All drug addicted women of childbearing age should be offered a LARC to prevent unplanned pregnancies and addicted babies. 

To prevent Zika virus birth defects in newborns during a Zika virus epidemic, all women who do not want to get pregnant should have access to a LARC. During the Zika virus outbreak in Brazil, women were counseled not to get pregnant, but contraception services were not provided. The same is happening in the United States. Women’s access to contraception is dependent on the state they live in. Many states have defunded Planned Parenthood and have not replaced it with an alternative for access to contraceptives. We must hold each state accountable for the provision of safe and effective contraception. Every state should provide LARCs for women who do not want to become pregnant. Find out what your state is doing to prevent unplanned pregnancies. Educate lawmakers about LARCs but don’t mention birth control. A LARC is every woman’s right.    


Mary Guinan, PhD, MD, was the founding dean of the School of Community Health Sciences at the University of Nevada, Las Vegas, and is now professor emerita. She was the first woman to serve as the chief scientific advisor to the director of the Centers for Disease Control and Prevention. Her memoir is entitled Adventures of a Female Medical Detective: In Pursuit of Smallpox and AIDS.

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