The contraceptive choice: If the pill is our past, long-acting reversible contraception (LARC) should be our future.

It’s hard to surmise the impact the contraceptive pill, known colloquially as “the pill” has had on sexual and reproductive freedom, and women’s liberation, since it first became available in Australia, in 1961.

Today, the pill remains one of the most popular forms of contraception in Australia, even as more effective methods such as long-acting reversible contraception (LARCs) have become increasingly accessible.

In recent years, the attitudes of women and pregnancy capable people have shifted to focus on the effects hormonal contraceptives can have on people’s bodies. The pill, which was once hailed as a symbol of empowerment and reproductive freedom, has been caught in the crosshairs of debate.

True’s Director of Nursing and Health Services, Lisa Harrison, explains, “For sexual and reproductive health professionals, navigating these conversations can be complex. But with more people of reproductive age turning to online communities for information on their contraceptive choices, it's important we cut through the noise and ensure everyone has access to accurate, evidence-based information and safe, quality care.”

Pill packet on blue pink background

The history of the pill

First made available in 1961, the pill was introduced into Australia with a hefty 27.5% luxury tax and was only available to married women. In 1972, during his first days in office, Gough Whitlam’s government removed this tax and added the pill to the Pharmaceutical Benefits Scheme, significantly reducing the cost and increasing its accessibility to all Australians.

“The contraceptive pill was one of the first contraceptive options available to women, and pregnancy capable people, that was both reliable, and independent — in that, unlike condoms it did not require the cooperation of a sexual partner,” says Lisa Harrison.

“Empowered to make free reproductive choices and control their family planning, women were more able to enter the workforce, continue their education, and earn their own money.”

In a time when contraceptive choices were limited, the pill rose to popularity, and has maintained its prevalence ever since.

Discussing the pill with your clients

ABC News recently published a comprehensive article that details the changing attitudes towards the pill, and the influence of social media in spreading misinformation.

In the article, they identify the main concerns for young people deliberating their contraceptive options are, the side effects, and the myth of hormone buildup. Most crucially, they highlight the source of most young people’s information on contraception comes from online communities, rather than trusted health professionals.

“The most critical need, first and foremost, is to ensure women, and people who menstruate, feel empowered to make their own choices, and that they are equipped with accurate information from a trustworthy source."

When it comes to discussing contraceptives with your clients, it’s important to be confident and understanding in your approach.

“There are many different types of contraceptive pills available in Australia, many of which differ in the type and dose of the hormones they contain,” says Lisa, “The side effects a person may experience while on the pill differ based on the individual and the pill they are taking. Health professionals should work with their clients to ensure they are prescribed the most effective birth control for their individual needs. This includes considering other options such as long-acting reversible contraception, which tends to be less maintenance and more effective.”

“Serious side effects that can occur from taking the pill, such as thrombosis, are rare,” explains Lisa. “Clients prescribed the pill should be counselled about their individual risk, based on their own situation."

At True, we have a range of free, easy to understand fact sheets and resources that health professionals can utilise when discussing contraceptive options with their clients.

You can view, send a link, or print them directly from our online library, linked below.

View Resources

Addressing hormone buildup

“The oral contraceptive pill is known as a short acting medication,” says Lisa, “It only works when taken regularly.”

And when it comes to ‘taking a break’ from birth control, it’s important to note; "Stopping and starting hormonal birth control can actually increase the risk of unintended pregnancy.”

“For people experiencing side effects, especially those that occur beyond 3 months of use, it is a good idea to speak to your health care professional.” Lisa reiterates, “Once again, it’s about ensuring clients feel informed about the choices they are making; and so, discussing their individual needs and concerns becomes key to empowered decision making.”

IUD on yellow blue background Long-acting reversible contraception (LARC)

Here at True, we have a lot of love for the pill and the doors it has opened for women, and pregnancy capable people, in Australia, over the last six decades.

But as we look to the future, we encourage everyone to consider the often-underestimated usefulness, and effectiveness, of long-acting reversible contraception.

“The great thing about long-acting reversible contraception options, such as IUDs and implants, especially in comparison to the pill, is their effectiveness isn’t dependent on the clients on reliability in using it. Unlike taking a pill once a day, after a LARC has been inserted, the client can ‘set and forget’ until they are ready to have it removed.”

“Plus, the copper IUD is non-hormonal, which makes it a potential option for clients wanting to avoid hormones, but wanting something more reliable than natural methods, or condoms.”

In 2022, our clinicians submitted their expert opinions to the Senate Inquiry report into ‘Universal access to reproductive healthcare’. We were one of many professional reproductive and sexual health organisations that highlighted the importance of LARCs to reduce unplanned pregnancies in Australia. In May 2023, the Senate released their report, with one of their key recommendations being a greater focus on availability of LARCs across Australia.

“Australia’s uptake of LARC has been slower than other countries, largely due to the cost of training and access in regional and rural areas,” says Lisa. “So, a focus on reducing these barriers at a federal level is critical to ending the postcode lottery of reproductive healthcare.”

Like it’s forebearer, the pill, which only became popular in Australia after its cost was reduced, and it became more readily available to the everyday person, if we want to see an uptake in LARC, we need to ensure it is affordable and accessible.

And, if we do continue to see a rise in contraceptive pill hesitancy, although in our opinion it seems unlikely that its popularity will wane anytime soon, LARC provides a diverse range of options for people to find a contraception that works best for them.

Lisa Harrison bio pic

Lisa Harrison is a highly skilled and experienced Reproductive and Sexual Health Nurse Practitioner with over 28 years' experience working as a clinician in Queensland.

Commencing her professional nursing career in 1995, Lisa studied as an undergraduate at Central Queensland University, and has completed further postgraduate studies at Monash University and the University of Queensland.

Lisa had a short affiliation with Charles Darwin University in their course development and teaching, and with her passion for improving health literacy and access to the adolescent population, Lisa developed and introduced the "Is It True" Program into Central Queensland Schools in 2018.

Lisa's professional nursing career has seen her as a Registered Nurse, an Advanced Sexual and Reproductive Health Nurse, Forensic Nurse Examiner and a Nurse Practitioner. Lisa was the former State-wide Nursing Officer - Clinical Governance before her appointment as the Director of Nursing & Health Services in August 2023.

With a commitment to increasing and improving reproductive and sexual health access and information, Lisa is excited to lead True's clinical and counselling services to continue to provide quality patient-centred care to all people in Queensland.

The contraceptive choice: If the pill is our past, long-acting reversible contraception (LARC) should be our future.

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