I have been using the contraceptive implant Nexplanon for 10 years now. I originally chose to get one in 2016; I wanted a birth control method that I couldn’t forget about or lose; Nexplanon goes underneath the skin on the inside of your upper arm. (Yes, you can feel the bump. No, it’s not for the squeamish. Neither is pregnancy).

At the time I got it, the implant had been certified to prevent pregnancy for three years. So three years later, in 2019, I called up my doctor at Planned Parenthood to make an appointment for a replacement. I was told that, actually, the implant was good for five years.

As a cheap Yankee who loves a bargain, I was thrilled with a buy-three-get-two-free deal. So I replaced mine in 2021, removed it in 2024 because I had reached the point in my life where I was ready to have a baby, got pregnant within four months of removal, had the baby and had my OB-GYN put my third implant in at my six-week postpartum visit.

I love Nexplanon. It’s hormonal, so it will affect different users in different ways, but it worked well for me, didn’t affect my fertility and makes for a fun party trick. 

Nexplanon was officially approved for a five-year lifespan by the FDA this year, on Jan. 16. Yay! However, at the same time, the FDA also imposed a new restriction on the implant. Boo! Also, suspicious — or “sus” as the youth might say.

Nexplanon has been placed under a monitoring protocol called a Risk Evaluation and Mitigation Strategy, an REMS. Out of the over 20,000 FDA-approved drugs, only 73 have an active REMS. They’re usually for drugs like opioids or chemotherapy drugs. Stuff that has important uses but can also do real damage.

Now you might be wondering, as I did (because I have one of these implants in my arm), did something about Nexplanon change? Did concerning safety data come out showing increased potential risks to patients? Fortunately, the answer is no. But that sure piqued my curiosity. If nothing has changed about the implant, why suddenly add a restriction to it? 

From my point of view as a patient who’s had three installed (and two removed), Nexplanon insertion is pretty straightforward. You get a little local anesthetic, then they use a device like a big needle to insert the implant under your skin. Removal involves more local anesthetic and a very small scalpel cut (my removal scar is about the size of the head of a matchstick).

I’ve had it done by a nurse practitioner and by an MD; can’t say I noticed a difference between the procedures. Medical providers have always been required to receive specific training in order to insert Nexplanon implants. This REMS is something new. 

It’s hard not to turn to slightly conspiratorial thinking about this. We can’t assume the current federal government is acting in good faith about anything. We know that conservative Republicans are obsessed with limiting abortion and forcing as many women through pregnancy as they can. But up until recently, most politicians have been careful about going after birth control, because birth control is insanely popular in America — 82% of reproductive age women (this is defined as ages 15-49) have used contraception in the past year.

Of women currently using contraceptives, Long Acting Reversible Contraceptives (LARCs), a category that includes intrauterine devices as well as implants, are almost as popular as the Pill. Overall, 11.4% of women using birth control choose the Pill, while 10.5% have an LARC. There’s evidence that LARCs are becoming more popular as more abortion restrictions are enacted across the country. If you live somewhere that gives you no way out of an unwanted pregnancy, you really want to do everything you can to prevent them in the first place. 

Here’s the thing: LARCs are more effective than the Pill, mainly because they eliminate a certain amount of user error — you don’t have to worry about missing a dose of an implant. Once installed, they are also immune to supply issues. You have to get pills refilled at a pharmacy every couple of months (except for an over-the-counter brand, Opill).

There’s a lot that can go wrong in that process, as anyone who’s ever filled a prescription could tell you. Then you add in the fact that various men in the Trump administration have been weirdly obsessed with the country’s fertility rate. (And it does seem to always be the men.)

Robert F. Kennedy Jr., the oddly orange head of the Department of Health and Human Services, which contains the Food and Drug Administration, talks a lot about sperm counts and recently said, “We had a series of presidents who were trying to discourage childbirth and motherhood in this country. We now have a president who is trying to encourage it.”

Dr. Mehmet Oz, head of the Centers for Medicare & Medicaid Services, recently said that Americans are “under-babied.”

It seems possible to me that this is the beginning of the Trump administration placing more restrictions on a safe, effective, long-lasting birth control method in order to push women into less effective methods and therefore into more unplanned pregnancies.

There is a lot going on in the world right now, but this is something to keep an eye on.