Abstract
ObjectiveTo determine the association between provider training level and postplacental intrauterine device (IUD) outcomes following insertion instruction by email only. Study designWe conducted a single-center chart review of demographics, insertion and clinical outcomes within 6 months of delivery for 116 patients who underwent postplacental levonorgestrel 52 mg IUD placement from October 1, 2016, to March 31, 2017. ResultsWe confirmed IUD retention, removal or expulsion in 87 of 116 (75.0%) patients by 6 months after delivery. Complete expulsion or removal for malposition occurred in 20 (23.0%) patients and more frequently after vaginal than cesarean delivery (30.2% vs. 4.2%, OR 9.93 [95% CI 1.25–78.96]) and when a postgraduate year (PGY) 1 physician placed the IUD compared to a PGY 2–4 or attending physician (37.5% vs. 14.5%, OR 3.52 [95% CI 1.25–9.94]). ConclusionPostplacental levonorgestrel 52 mg IUD expulsion rates are associated with provider training level as well as delivery route, though the individual association of each of these factors is difficult to ascertain given the high degree of collinearity between these two variables in our study.
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