Barriers to Immediate Postplacental Intrauterine Devices Among Attending Level Educators [190

Abstract

INTRODUCTION: The purpose of the study is to determine whether there are barriers to immediate postplacental intrauterine device (IUD) placement at the health care provider level. METHODS: Obstetric providers at seven academic teaching hospitals in Massachusetts were asked to complete an electronic survey regarding their knowledge, experience, and opinion of immediate postplacental IUDs. The survey tool was designed through the research electronic data capture (REDCap) software and contacts at the seven academic teaching hospitals in Massachusetts were e-mailed to send the survey to their colleagues. Demographic data, including type of health care provider and location of care, were collected as well as training, knowledge, and experience with postplacental IUDs in the form of multiple-choice questions. The survey was e-mailed twice during the study period. The data were analyzed using MATLAB and Excel. RESULTS: Eighty-two health care providers including obstetricians, family medicine physicians, and midwives completed the survey with a response rate of 29%. Thirty-five (42.7%) reported experience placing an immediate postplacental IUD with the majority of them having placed three to five postplacental IUDs. Of participants who had never placed a postplacental IUD, the reason cited most frequently was inadequate training. Less than half (43.4%) correctly identified the postplacental IUD expulsion rate, whereas 75.9% knew the correct expulsion rate for interval IUD placement. The majority of health care providers responded that postplacental IUDs are acceptable in certain clinical scenarios. CONCLUSION: Overall acceptance of postplacental IUD placement is high among health care providers. However, experience and knowledge are relatively low. Additional training opportunities are needed to close this gap.