A national study to monitor the safety of IUCD use

Abstract

Objective: To determine whether the known adverse effects of IUD use were being kept to a minimum in a population of women. Design: A national survey of all doctors purchasing IUDs in a three-month period. Information was sought on the doctors' training, experience and usual insertion practice, and also on characteristics of each woman receiving an IUD in the study period. Main outcome measures: Published national and international guidelines on selection of users for IUDs and on training for IUD insertion were compared with our findings on these measures. Results: Not all IUD insertions were in accordance with published guidelines. Very few IUD insertions (0.9%) were carried out in the face of absolute contraindications to this type of contraception. However, 126 insertions (27%) were for women who had a relative contraindication, excluding an uncompleted family. Gynaecologists were significantly less likely to fit an IUD in the presence of contraindications than other doctors. Few doctors reported training to the standard recommended. Conclusions: That the known adverse effects of IUD use are not being kept to a minimum for New Zealand women. The study design could be used to estimate the potential for adverse effects in populations for other types of contraceptives.