What influences young women to choose between the emergency contraceptive pill and an intrauterine device? A qualitative study

Abstract

Women need better information and education about the IUD as a highly effective method of EC. Health professionals must provide such information at every opportunity. Showing the IUD during counselling might help correct misconceptions and would improve acceptability. Wider availability of expertise concerning EC-IUDs is essential to assist more women in making informed decisions when choosing a method for EC.

The copper intrauterine device for emergency contraception: an opportunity to provide the optimal emergency contraception method and transition to highly effective contraception

“…Women viewed it as something to use once they were finished childbearing. Knowing someone who had a good experience with the IUD, having prior personal experience with the IUD, being able to see the device or having accurate knowledge about the IUD side effects, safety and efficacy were more commonly seen in women who chose the IUD for EC [94,99]. The 'long acting' aspect of the IUD was seen as both a benefit and a reason not to use it [99,100].…”

“…Other potential barriers identified from US and European studies, in addition to concern over cost, are awareness of the IUD as a method of EC, misconceptions about the IUD and its side effects, especially regarding future fertility, fear of the insertion process and the idea of using a long-acting device [98][99][100]. Women who did not know the IUD could be used for EC were less likely to choose that method.…”

“…Knowing someone who had a good experience with the IUD, having prior personal experience with the IUD, being able to see the device or having accurate knowledge about the IUD side effects, safety and efficacy were more commonly seen in women who chose the IUD for EC [94,99]. The 'long acting' aspect of the IUD was seen as both a benefit and a reason not to use it [99,100]. Women who were in relationships looked more favorably on the duration of effectiveness, while those not in a relationship did not think using a longer acting method was necessary and instead viewed it as a deterrent [100].…”

“…Disruption of workflow is routinely identified by providers as a barrier to providing the IUD for EC [99,101,102,106,113]. Many clinics also require two visits prior to inserting an IUD, a practice that is of no demonstrated benefit and results in poor return rates [98,113].…”

Use of IUDs for emergency contraception: current perspectives

“…50 In the small study by Wright et al, women considered the use of contraception in the context of each relationship and associated long-acting methods with long-term relationships. 50 This, and other studies from USA, [51][52][53] not only highlight lack of knowledge as a significant factor in the underuse of the emergency IUD, but also indicate that around one in eight women would be interested if the procedure could be done on the day of presentation, involved one visit, and was free of charge.…”