Last week, I mentioned that the director of DSS stopped by to talk to me about her plans for the agency and her love for the Brookings Institute. She asked me to watch a couple of videos, all of which I will share at some point this summer but the first is linked to the book she also asked me to read and I already have some basic knowledge on the topic so we’re starting with LARCs, or Long Acting Reversible Contraceptives. Short yet informative video below.

Now, I’m just going to say this before we go too far, both Bell and I think that single parents often do a wonderful job at raising children (I’m the daughter of a single mother and I think I’m pretty great) and I can’t speak for Bell on this one but I fully believe that two or more people can get together and decide to raise a child without the institution of marriage. Bell focuses a lot on the marriage part but I think the bigger picture is that 1) with more than one person raising a child, there are more resources to go around and the child is more apt to thrive and 2) a lot of the instances of single-parenthood aren’t choices that are made but instead instances of a lack of resources. Here at the DSS, we like to let people know their options and LARCs give women in a lot of at-risk categories (young, uneducated, racial minorities, low income, or usually some mixture) more chances to choose. Another important factor in getting access to any kind of birth control is being able to afford it. The DSS provides applications for Medicaid to clients who may qualify and fortunately for people on Medicaid LARCs (and actually birth control in general) is covered so that there is no out of pocket cost.

So lets get a LARC lowdown.

ParaGard/Copper IUD


  • Hormone free which means it won’t mess with the hormones you already have and that it functions by thickening the cervical mucus in order to block sperm.
  • Can last 10-12 years (!!!)
  • Is more than 99% effective (comparable to male/female sterilization)
  • You can have sex immediately after placement (no waiting like with the pill)
  • Can be used while breastfeeding
  • Ability to become pregnant returns quickly after removal


  • While the procedure for placing the IUD may be quick, it is not painless. In order to place the IUD, your doctor has to open your cervix. I know many people who have IUDs and while they often say it’s the best choice they’ve ever made, they also say it’s one of the most painful things they’ve ever gone through. From what I’ve heard and read, reports of the procedure being painful mostly come from women who have never given birth and that women who have don’t think it’s that bad. So take that as you will.
  • Heavier and longer periods are common (although that should end within 2-3 months) and I have heard a lot of personal stories about very painful cramping.

Mirena/Hormonal IUD


  • Can last anywhere from 5 to 12 years depending on the brand
  • Functions by preventing the egg from leaving the ovary and thickens cervical mucus to block sperm (two things are happening at once which personally just makes me feel better)
  • Also 99.9% effective
  • May reduce period cramps and on average menstrual flow is reduced my 90% (some women stop having a period all together)
  • Can be used during breast feeding but because this one is hormonal women should wait 4 weeks after giving birth to get this kind of IUD
  • Ability to become pregnant returns quickly
  • You can begin to have sex immediately after the IUD is placed if it is inserted within 7 days of the start of your period


  • Just like the copper IUD, the insertion of the IUD can be very uncomfortable. I hear it’s worth it but if you don’t have a high pain tolerance, you should know in advance.
  • 3-6 months of irregular periods



  • Lasts 3 years
  • Relatively easy insertion. Basically, a doctor takes the implant that’s about the size of a matchstick and inserts it into the underside of your arm. Most women I’ve spoken to say that it’s only as painful as a shot.
  • Functions by releasing progestin (a hormone you already produce naturally) which keeps the egg from leaving the ovary and thickens cervical mucus. Like I said earlier, I just like knowing that more than one action is taking place. It feels like a fail safe.
  • 99.9% effective (I’m loving the odds of the LARCs)
  • Can have fewer, lighter periods after 6-12 months and 1 in 3 women will stop having periods entirely
  • You can begin having sex immediately if the implant is placed within the first 5 days of your period
  • Can be used while breastfeeding
  • Can become pregnant quickly after removal


  • Can interact negatively with medications
  • Irregular bleeding in the first 6-12 months and some women report heavier, longer periods

So those are the big things about LARCs I thought everyone would want to know. Just as a reminder I AM NOT A DOCTOR. Always consult with your doctor to make sure any form of birth control is right for you. If you choose any LARC from the list above and experience prolonged, negative symptoms, speak with a doctor immediately. I want everyone to be happy with the choices they are making about their bodies and futures, which means being safe. If you aren’t on Medicaid but are thinking of getting a LARC, call your insurance company to check.

I hope this was helpful in some way. If anyone has any questions, just leave a comment and I’ll do my best to answer. More next week!






I’ve also used personal stories from friends and family. Most of the time people you have relationships with care about you and aren’t invested in selling you something so I think it helps to hear from real people.


#1 Suzanne Raitt on 05.27.16 at 10:43 am

Hi Sadie, thanks for this awesome, informative post. I really liked the way you blended facts about the LARCs and the way they each work, with information about how women who might want or need them can access them via the DSS. Great to have the personal input too, from women who’ve experienced them. It sounds as if your internship is exposing you to lots of interesting ideas, information and people. Birth control is such a personal choice but I had no idea that the failure rate for condoms and the pill is so high! Makes me feel that anyone who is having heterosexual sex and DOESN’T experience an unplanned pregnancy is just…I was going to write lucky, but then, unplanned pregnancies with really good support aren’t necessarily negative experiences. It’s just that the vast majority of people don’t have the support and the resources that can make the experience a supremely positive one, and anyone who doesn’t want to get pregnant should have access to devices or drugs that can really protect them. Those are amazing success rates for the LARCs. They exist, so we should know about them! And thanks to you, a few more people soon will.

#2 Sadie on 05.27.16 at 6:08 pm

You make a great point, the rate of pregnancy even with contraceptives is amazing. If someone isn’t planning to have a child and thinks they are taking all of the necessary precautions then they can really be left out in the rain if they do end up pregnant. If they have plenty of resources, be it money or family or a supportive community, then it is a lot easier for them to do well or even thrive. DSS works with many people with limited resources and who may already have had experiences with failed contraceptives and are concerned about supporting more children with their limited resources. If they are unaware of LARCs and don’t want to have children right now then they may feel helpless, like having an unplanned pregnancy is inevitable. We want to help them in any way we can so that they can have control over their lives and make informed decisions.

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