Long Acting Reversible Contraception (LARC) Key Clinical Indicator (KCI)
Year ending 31 March 2026

About this release

This annual release by Public Health Scotland (PHS) reports on the prescribing of long acting reversible methods of contraception (LARC) in primary care and sexual health settings in Scotland. This includes the contraceptive implant, intrauterine device (IUD) and intrauterine system (IUS). Contraceptive injections are also reported on but are presented separately. These data are based on the NHS board of prescription.

Main points

In primary care and sexual health settings combined in 2025/26:

• LARC prescription rates fell again in 2025/26, continuing the recent downward trend in both sexual health and general practice services.

A line chart showing LARC (IUD + IUS + Implant) prescribing rate per 1,000 women aged 15-49 by total and by each NHS setting of prescription in Scotland for the last 10 financial years (2016/17 to 2025/26). The chart shows variations in rates by general practice and Sexual Health Services. Each setting trend is represented by a different colour of line.

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LARC prescribing rate by NHS setting of prescription

• Prior to the COVID-19 pandemic, prescription rates were stable in general practice and increasing in sexual health services. There was a sharp decrease in LARC prescriptions during 2020/21. This was more marked in general practice.
• This was followed by an acceleration of increasing abortion rates suggesting an impact of reduced LARC prescriptions on unintended pregnancy rates.
• The initial post-pandemic recovery of LARC prescription rates was greater in sexual health services than in general practice where rates did not recover to their pre-pandemic levels.
• Since 2022/23, LARC prescription rates have been decreasing in both sexual health and general practice services but to a greater extent in general practice.
• In January 2024, the UK Medicines and Healthcare Products Regulatory Authority approved an extension to the duration for which one specific and popular brand of IUS, the Mirena hormonal coil, is licensed for contraception, from 5 to 8 years. While this will be a factor in falling prescription rates for the IUS and therefore overall LARC, it does not account for similar decreases which have been observed for the contraceptive implant and the IUD.
• Differences in trends between general practice and sexual health services and considerable variation across mainland health board areas (from a rate of 60.2 per 1,000 women aged 15 to 49 years in NHS Highland to 30.3 in NHS Lanarkshire) suggests service accessibility may also be a contributing factor in decreasing LARC prescription rates.
• In some health boards the same staff provide both abortion and LARC services, therefore increasing need for abortion to treat unintended pregnancy may mean less capacity to prevent unintended pregnancy through LARC provision.
• There is evidence unintended pregnancies which are continued can impact on women’s income and employment progression, maternal mental health, and risk of preterm birth. Increasing accessibility of LARC services is therefore a priority for women’s health in Scotland.

Background

In typical use, the long acting methods of contraception can have a lower failure rate than alternative reversible methods such as the contraceptive pill or condoms. In August 2021, Reset and Rebuild: A Recovery Plan for Sexual Health and Blood Borne Virus Services was released, detailing the impacts of the COVID-19 pandemic on sexual health and blood borne virus services in Scotland. In 2023 the Sexual health and blood borne virus action plan (2023-2026) was published. Increasing the availability of LARC is also one of the aims of the Scottish Government's Women's Health Plan which seeks to drive forward change and improvement in women's health.

Further information

The next release of this publication will be September 2027.