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Contraception. 2014 Jul;90(1):54-9. doi: 10.1016/j.contraception.2014.01.025. Epub 2014 Feb 7.

Interest in and experience with IUD self-removal.

Author information

1
University of California, San Francisco, CA, USA. Electronic address: fosterd@obgyn.ucsf.edu.
2
Ibis Reproductive Health, Cambridge, MA, USA.
3
University of Utah, Salt Lake City, UT, USA.
4
Washington University in St. Louis, St. Louis, MO, USA.
5
Institute for Family Health, New York, NY, USA.
6
University of Pennsylvania, Philadelphia, PA, USA.
7
University of California, San Francisco, CA, USA.
8
University of Pittsburgh, Pittsburgh, PA, USA.

Abstract

OBJECTIVES:

In the United States, the popularity of intrauterine devices (IUDs) is low despite many positive attributes such as high effectiveness and ease of use. The requirement that a clinician remove the IUD may limit US women's interest in the method. Our objective was to describe women's experience with self-removal and its effect on attitudes toward the method.

STUDY DESIGN:

We assessed interest in attempting and success in IUD self-removal among women seeking IUD discontinuation from five US health centers. Women were given the option of attempting self-removal of the IUD. Participants were asked to complete two surveys about their reasons for desiring IUD removal, attitudes toward IUD use and experience with self-removal and/or clinician removal.

RESULTS:

Three hundred twenty-six racially diverse women participated (mean age, 28 years; body mass index, 27; duration of IUD use, 3 years); more than half were willing to try self-removal [95% confidence interval (CI): 45-65%], and among those who tried, one in five was successful (95% CI: 14-25%). More than half of participants (54%) reported they were more likely to recommend IUD use to a friend now that they know that it might be possible to remove one's own IUD; 6% reported they were less likely to recommend the IUD to a friend. African American women were particularly interested in the option of IUD self-removal.

CONCLUSIONS:

Many women are interested in the concept of IUD self-removal, although relatively few women currently succeed in removing their own IUD.

IMPLICATIONS:

Health educators, providers and advocates who inform women of this option potentially increase IUD use, reducing rates of undesired pregnancy.

KEYWORDS:

Contraceptive attitudes; IUD; Intrauterine contraception; Self-removal

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