Publication Date

Spring 2014

Degree Type

Doctoral Project

Degree Name

Doctor of Nursing Practice (DNP)



First Advisor

Deepika Goyal


LARC, Same day insertion, Early removal


Objective: The study was conducted to identify the early removal rate of Long-Acting Reversible Contraceptive (LARC) methods and factors associated with early removal.

Study Design: A non-experimental descriptive design based upon retrospective chart review of electronic medical records (EMR) was used. There was a total of 96 subjects, ages 15-47 years who had a LARC method inserted within a 12-month time period and subsequent removal within 6-months of insertion date. Subjects were grouped according to same-day insertion versus non-same-day insertion.

Results: Seventy percent of study subjects with early removal had their LARC method inserted under a same-day protocol. Most subjects were over 20 years of age, single, and of Hispanic ethnicity. The overall early removal rate for all LARC methods was 5%. Implant was the method most commonly removed followed by the levonorgesterel intrauterine system (IUS). Pain and bleeding were the most commonly cited reasons for removal. Oral contraceptive pills (OCPs) were the most commonly selected birth control method after removal of the LARC.

Conclusion: A strategy to reduce barriers to contraceptive initiation is same-day insertion of the requested LARC method. However, research on LARC methods in conjunction with same-day initiation and continuation rates has not been done. This pilot study demonstrates a low early removal rate for LARC methods and offers support for a same-day initiation protocol.


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