The following recommendations have been identified as priorities for implementation.
Contraceptive provision 1. Women requiring contraception should be given information about and offered a choice of all methods, including long-acting reversible contraception (LARC) methods. 2. Contraceptive service providers should be aware that: - all currently available LARC methods (intrauterine devices, the intrauterine system, injectable contraceptives and implants) are more cost effective than the combined oral contraceptive pill even at 1 year of use - intrauterine devices, the intrauterine system and implants are more cost effective than the injectable contraceptives - increasing the uptake of LARC methods will reduce the numbers of unintended pregnancies.
Counselling and provision of information 1. Women considering LARC methods should receive detailed information ; both verbal and written ; that will enable them to choose a method and use it effectively. This information should take into consideration their individual needs and should include: - contraceptive efficacy - duration of use - risks and possible side effects - non-contraceptive benefits - the procedure for initiation and removal/discontinuation - when to seek help while using the method.
Training of healthcare professionals in contraceptive care 1. Healthcare professionals advising women about contraceptive choices should be competent to: - help women to consider and compare the risks and benefits of all methods relevant to their individual needs - manage common side effects and problems. 2. Contraceptive service providers who do not provide LARC within their own practice or service should have an agreed mechanism in place for referring women for LARC. 3. Healthcare professionals providing intrauterine or subdermal contraceptives should receive training to develop and maintain the relevant skills to provide these methods.