• Alicia T Luchowski, Britta L Anderson, Michael L Power, Greta B Raglan, Eve Espey, and Jay Schulkin.
• Long-Acting Reversible Contraception Program, The American College of Obstetricians and Gynecologists, Washington, DC. Electronic address: aluchowski@acog.org.
• Contraception. 2014 Jun 1;89(6):578-83.

ObjectivesLong-acting reversible contraception (LARC) - the copper and levonorgestrel intrauterine devices (IUDs) and the single-rod implant - are safe and effective but account for a small proportion of contraceptive use by US women. This study examined obstetrician-gynecologists' knowledge, training, practice and beliefs regarding LARC methods.DesignA survey questionnaire was mailed to 3000 Fellows of the American College of Obstetricians and Gynecologists. After exclusions, 1221 eligible questionnaires were analyzed (45.8% response rate, accounting for exclusions).ResultsAlmost all obstetrician-gynecologists reported providing IUDs (95.8%). Most obstetrician-gynecologists reported requiring two or more visits for IUD insertion (86.9%). Respondents that reported IUD insertion in a single visit reported inserting a greater number of IUDs in the last year. About half reported offering the single-rod implant (51.3%). A total of 92.0% reported residency training on IUDs, and 50.8% reported residency training on implants. Residency training and physician age correlated with the number of IUDs inserted in the past year. A total of 59.6% indicated receiving continuing education on at least one LARC method in the past 2years. Recent continuing education was most strongly associated with implant insertion, and 31.7% of respondents cited lack of insertion training as a barrier.ConclusionsBarriers to LARC provision could be reduced if more obstetrician-gynecologists received implant training and provided same-day IUD insertion. Continuing education will likely increase implant provision.ImplicationsThis study shows that obstetrician-gynecologists generally offer IUDs, but fewer offer the single-rod contraceptive implant. Recent continuing education strongly predicted whether obstetrician-gynecologists inserted implants and was also associated with other practices that encourage LARC use.Copyright © 2014 Elsevier Inc. All rights reserved.

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