Reporting a few cases of negative side effects is alarmist and damaging
A story aired on the ABC that reported on issues concerning long-acting contraceptives was unbalanced and alarmist writes Associate Professor Kirsten Black.
Last night ABC’s 7.30 featured a report on long-acting reversible contraception (LARC) that was unbalanced and alarmist. This could have a long-lasting detrimental impact on women’s reproductive health in Australia.
The segment focused on the contraceptive implant (Implanon NXT) and the intrauterine system (Mirena) and presented two cases of women who experienced adverse side effects from use of these methods.
The report completely failed to present the experience of the majority of women who are happy with these devices and reap many benefits. These include reduced period bleeding and pain, as well as reliable protection from unintended pregnancy.
In studies where women are followed up a year after commencing one of these methods, over 80% of women continue to use them. This reflects high levels of satisfaction.
The figures of adverse events quoted by the ABC demonstrate how uncommon any major complications are - affecting less than one in a thousand women. Large patient trials have consistently found these devices to be extremely safe and highly effective at preventing pregnancy.
All consultations about contraception involve discussing the risks and benefits of different methods. Women should be able to make a fully informed decision that best suits their needs.
A large study in the US (the CHOICE study) involving more than 7,000 women showed, when provided with evidence-based information, more than two-thirds of women chose a LARC method with high levels of continuation and satisfaction.
The body of evidence in favour of the use of long-acting contraceptive methods is so strong the World Health Organisation supports strategies to increase their uptake. Increasing access to LARC methods is a health priority of governments in the US and UK.
The reason for this widespread support for LARC methods comes from reports finding half of unintended pregnancies result from use of contraceptive methods that require daily adherence such as pills and condoms. No interventions have been found to improve regularity or consistency of use of these methods, nor to lower unintended pregnancies.
Because of high fertility and less reliable adherence to contraceptive methods, adolescents and young women may be particularly susceptible to unintended pregnancy.
The CHOICE study in the US reported that among all 14-45 year-old women, 67% chose to use an implant or an intrauterine device. When followed up for three years their risk of unintended pregnancy was 20 times lower compared with women who had chosen to use a contraceptive pill, patch or ring, which require taking or changing regularly.
This reporting by the ABC is irresponsible and detrimental to women’s health. Dedicated health professionals strive to improve the reproductive health outcomes of women in Australia and beyond, and unbalanced reporting could negatively affect progress in this area.
Unintended pregnancies have an enormous impact on the economic, social, psychological and physical aspects of women’s lives. International consensus supports the safety and efficacy of LARC as the most effective public health strategy to address this.
Associate Professor Kirsten Black is Joint Head of the Discipline of Obstetrics, Gynaecology and Neonatology. This article was originally published on The Conversation.