DoH pushes LARCs to cut teen pregnancy rate

GPs warn that DoH should not force young people to choose LARCs over other contraception.

GPs have welcomed plans to increase the use of long-acting reversible contraceptives (LARCs) to cut teenage pregnancies, but warned young people should not be coerced.

The DoH has sent letters to 21 PCTs in England, where rates of teenage pregnancies have risen, calling for 'urgent action' to bring about 'an overall increase in the uptake of LARCs'.

Areas targeted include Bristol, Manchester, Blackpool and the London boroughs of Croydon, Enfield, Haringey and Barking and Dagenham. GPs said local quality indicators could boost LARC uptake in these areas.

This latest push for LARCs comes just a month after sexual health was added to the quality framework for the first time.

Three indicators will be included in the 2009/10 framework that will offer 10 points to practices producing a register of women who have been prescribed contraception and who have received information about LARCs (GP, 17 October).

Dr Richard Ma, a member of the RCGP's sex, drugs and HIV working party, said: 'NICE issued guidance on LARCs back in 2005 but the uptake is still not that great.

'We need to increase uptake and let women know that it is a reliable form of contraception.'

GPs should ensure that they maintain their skills in providing LARCs and have experience in fitting IUDs, he said.

'But teenage girls should not all be made to have a contraceptive injection. They should be given a choice of what contraceptive they decide to use because the injection is not the best choice for everyone.'

Dr Ma added that a local quality framework could play a part in the delivery of LARCs.

'Clearly some public health problems are not universal. Some areas have higher rates of abortions and teenage pregnancies than others, so some local relevance would be helpful.'

A spokeswoman for the DoH stressed that the plan was not to force teenagers to have a contraceptive jab but to improve access to effective contraception methods for those who are sexually active.

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