Barriers and facilitators to the delivery and uptake of long-acting reversible contraception


What are the views of general practitioners?

Chief Investigator: Professor Danielle Mazza, Department of General Practice, Monash University

Unintended pregnancies  have long been identified as a significant public health problem both in  Australia and internationally. In Australia, around 51% of women have  experienced an unintended pregnancy in their lifetime [1] and, according to US data,  about half of these end in abortion [2].  While there is strong evidence that the increased use of long-acting reversible  contraceptives (LARCs; eg, intrauterine devices and implants) has the potential  to reduce unintended pregnancy and abortion rates, only 3-5% of Australian  women who are at risk of pregnancy use LARCs [3,4].

In Australia, general  practice is the “first line” in the delivery of contraception to women and the  management of sexual and reproductive health concerns. General practitioners  (GPs) therefore play a central role in the delivery of contraception to Australian  women and their views on contraception can influence the type of advice that  they provide and the type of contraception used by patients [5-7].  However, little is known about the views of Australian GPs in relation to  promoting the use of LARCs among women who are at risk of pregnancy. Recent  analysis of Australian general practice consultations using data from the  Bettering the Evaluation and Care of Health (BEACH) program indicate that only  6.9% of all contraception consultations involve LARCs [8].

Researchers at the  Department of General Practice, Monash University, are investigating the  reasons for the inadequate delivery and uptake of LARCs among women who attend  general practices. The team have recruited GPs from around Australia to  participate in semi-structured telephone interviews. Results from this study  will identify key barriers and facilitators to the uptake of LARCs in the  general practice setting and will inform the development of interventions  tailored to close the evidence-practice gap.


  1. Marie Stopes International  Australia. Real choices: women, contraception and unplanned pregnancy.  Melbourne: 2008.
  2. Jones RK, Darroch JE, Henshaw  SK. Contraceptive use among U.S. women having abortions in 2000-2001. Perspect  Sex Reprod Health. 2002;34(6):294-303.
  3. Gray E, McDonald P. Using a  reproductive life course approach to understand contraceptive method use in  Australia. J Biosoc Sci. 2010;42(1):43-57.
  4. Richters J, Grulich AE, de  Visser RO, et al. Sex in Australia: contraceptive practices among a  representative sample of women. Aust N Z J Public Health. 2003;27(2):210-6.
  5. Middleton AJ, Naish J, Singer  N. General practitioners' views on the use of the levonorgestrel-releasing  intrauterine system in young, nulligravid women, in London, UK. Eur J  Contracept Reprod Health Care. 2011;16(4):311-8.
  6. National Collaborating Centre  for Women’s and Children’s Health. Long-acting reversible contraception: The  effective and appropriate use of long-acting reversible contraception. London:  RCOG Press; 2005.
  7. Wellings K, Zhihong Z, Krentel  A, et al. Attitudes towards long-acting reversible methods of contraception in  general practice in the UK. Contraception. 2007;76(3):208-14.
  8. Mazza D, Harrison C, Taft A, et  al. Current contraceptive management in Australian general practice: an  analysis of BEACH data. Med J Aust. 2012;197(2):110-4.