Procedural Clinic for Long Acting Reversible Contraception (LARC)

Role of service

The Procedural Clinic sees women for the insertion and removal of Long-Acting Reversible Contraceptive (LARC) methods when this is unable to be managed in primary care for medical reasons or where there has been failure of insertion or removal in primary care.

Non-hormonal and hormonal intrauterine devices and subdermal contraceptive implants are available from the Hospital Pharmacy.

Patients will be referred to their GP for follow up after insertion of LARC.


Clinical inclusion criteria

  • Women requiring LARC with medical reasons that cannot be done in the community or post-natal ward settings
  • Prior caesarean section at WNHS
  • Failed insertion by a service provider in the community or post-natal ward setting
  • Failed removal of LARC
    • Impalpable or deep subdermal implant requiring removal
    • Failed removal of intrauterine device


Clinical exclusion criteria

  • Women requiring routine contraception who are suitable for community or post-natal ward management;
  • Women requiring LARC insertion for gynaecological conditions (e.g. adenomyosis / endometriosis, heavy menstrual bleeding, menopausal hormonal therapy, chronic pelvic pain);
    • Refer these patients to General Gynaecology for first assessment and planning management and an internal referral may be made to the LARC clinic for review if Mirena is advised


Frequency of clinic

Weekly on a Monday afternoon.


Referral to include

  • Details of current contraception.
  • Current CST if age >25yrs.
  • STI screen result.
  • Copies of X rays or ultrasound locating subdermal implant / IUD if impalpable or no strings visible

Note: When you refer patients to this clinic for IUCD insertion. Please advise your patients that they need to use effective contraception until IUCD insertion is completed.


Urgent referral

Ring KEMH Switchboard (08) 6458 2222 and ask for On Call Gynaecology Registrar (or Consultant if case is complex).


Referral process

All referrals from GPs to this clinic are sent to the Central Referral Service WA (CRS). Ensure you provide the relevant information in the referral to enable appropriate triage, including required investigation results and letters from treating medical practitioners if relevant and request LARC clinic at WNHS.

Referrals using GP software that include all the relevant history and information are also welcome using CRS referral form templates (external site).

Referrals are sent to the Central Referral Service of WA via:

Healthlink secure messaging: crefserv
Tel: 1300 551 142
Fax: 1300 365 056
Postal address: GPO Box 2566, Perth WA 6831

Last Updated: 05/12/2023