Health Advocacy Spotlight

Women of color and women of low socioeconomic status experience some of the highest rates of unintended pregnancy, high-risk birth and lack of abortion across the country. Long Acting Reversible Contraception (LARC) methods are proven to be the most effective reversible contraceptive methods and have the highest rates of continuation and satisfaction among users.

In 2014, the ACOG American Indian/Alaska Native Women’s Health Program received a generous grant of $144,160 to expand access to LARC by providing a new, evidence-based, hands-on training to providers serving American Indian/Alaska Native women residing in rural and remote communities. A total of 36 providers were trained across 12 states. Sixty-four percent of the facilities who participated in this program inserted 50 or fewer LARC devices with confidence in the previous year. After the ACOG training program, just over 100 LARC devices were placed with competence and confidence by trainees at these facilities three months’ post program completion.

ACOG’s initial review of data shows that this new model of training is successful. The project included:

  1. a preliminary needs assessment of access to LARC methods in IHS and Tribal facilities,
  2. an on-site training,
  3. follow-up visits led by expert LARC faculty or by on-site providers previously trained in and comfortable with LARC insertion and
  4. continued outreach and support for trainee’s 4-6 months’ post training.

Testimonials from trainees at both IHS and Tribal facilities were ecstatic:

“Prior to the LARC training, I would not have considered placing an IUD in a 16-year-old, primarily due to the ‘pain’ of the procedure. The trainer assured me that cervical anesthesia is not usually required. I was skeptical. Well, today, I placed an IUD in a 16 y/o girl…without difficulty. Smooth as butter. With education prior to, and reassurance during the procedure, this 105 lbs girl did very well. She desired to change from Depo Provera to an IUD after hearing her sister talk about the advantages of an IUD. #FeelingKindOfProud”

“Even though I received training several years ago, it was very relevant to undergo additional training since I had experienced some technical issues during insertions that were not addressed during my initial training. I am more competent and skilled with insertion/removal for LARC methods.”

While the ACOG American Indian/Alaska Native Women’s Health Program is thrilled with the initial results of the training, there is still much work to be done.

In order to address these needs ACOG will continue to work on this topic in collaboration with other work we are already scheduled to do. After the AI/AN Women’s Health Committee 2017 site visit to the Great Plains and Billings Areas, the ACOG AI/AN Women’s Health Program will supplement its three-day, postgraduate regional course with this new model of LARC training. This course, for Great Plains and Billings Area providers, will also include a one-day AI/AN women’s health update and ALSO (Advanced Life Support in Obstetrics) training.

If you are interested in supporting this opportunity for American Indian/Alaska Native Women through financial gifts or medical supplies donations, please contact Yvonne Malloy, Director of American Indian/Alaska Native Women’s Health ( and Elizabeth O’Connell, Director of Development, Underserved and International Women’s Programs ( 



Yvonne Malloy
Native American Health Programs


American College of Obstetricians and Gynecologists
409 12th Street SW, Washington, DC  20024-2188
Mailing Address: PO Box 96920, Washington, DC 20024-9998