Intrauterine Device Utilization Research Articles

Analysis Of Factors Associated with The Use of IUD in Women of Childbearing Age

The Intra-Uterine Device (IUD) stands out as one of the safest long-term contraceptives, boasting a remarkable user effectiveness rate of 99.4%. Despite this, recent data from the 2021 Indonesian health profile in South Kalimantan Province reveals suboptimal coverage of IUD usage. Specifically, the coverage stands at 1.95% with 12,011 users in the region, 1.02% (477 users) in Kotabaru District, and 1.79% (82 users) in the Serongga Health Center. These figures fall short of the targeted coverage of 12.9%. This study aims to identify factors influencing IUD usage among women of childbearing age. Employing an analytical observational method with a Case-Control design, the research was conducted within the Serongga Health Center's jurisdiction. The investigation sought to establish correlations between education, knowledge, occupation, age, parity, and husband support with the utilization of IUDs among women of childbearing age. Utilizing a cluster proportional random sampling technique, the study comprised a sample population of 110 individuals. Statistical analysis involved the application of the Chi-Square test and Logistic Regression test for multivariate analysis. The findings of the study indicate that education (p=0.554), knowledge (p=0.308), age (p=0.566), and parity (p=0.835) demonstrate no significant association with IUD usage among women of childbearing age. Conversely, occupational factors (p=0.022, Exp (B)=2.667) and husband support (p=0.035, Exp (B)=2.813) exhibit a notable association. Notably, occupation emerges as the dominant factor influencing IUD usage.

Why intrauterine device (IUD) utilization is low in southwestern Ethiopia. A mixed-method study.

An intrauterine device (IUD) is a highly effective long-acting and reversible contraceptive method widely available around the world. However, only a small proportion of women in developing countries, including Ethiopia, are currently using the method. Therefore, this study aimed to identify why IUD utilization is low in southwestern Ethiopia. A mixed-method study involving health facilities and communities was conducted. The focus group discussions and key informant interviewees for the qualitative study were selected purposively, whereas 844 women family planning users were selected using systematic random sampling from November 1-30, 2020. Quantitative data was collected using Open Data Kit and analyzed using Stata version 16.0. Multivariable logistic regression analyses were done to identify significant factors influencing IUD use. The qualitative data were tape-recorded, transcribed, and finally, thematic analyses were done. A total of 784 participants were involved in the study yielding a response rate of 92.9%. Among all respondents, only 1.3%, 2.4%, and 30.0% had been using an IUD, preferred an IUD, and had the intention to use an IUD, respectively. The main reported barriers to use an IUD among qualitative participants were fear of side-effects, religious prohibitions of contraception use, husband disapproval, lack of training by health workers, misconceptions, and longer duration of use. IUD information (AOR = 2.19 [CI: 1.56-3.08]), and rich wealth status (AOR = 1.70 [CI: 1.13-2.56]) were associated with the intention to continue or start to use an IUD. IUD use and information on IUDs in the study area was very low. Information about IUDs, wealth status, and partner disapproval were determinant factors for intention to use an IUD. Thus, a regular awareness creation program using accessible media platforms by the government and stakeholders on IUD use is necessary to provide reliable information to the community and resolve misconceptions. In addition, women's empowerment to balance partner dominance on decision-making of contraception use and health care worker training on long-acting reversible contraceptives (LARCs) to increase access to LARC services are necessary to increase uptake of LARCs in general and of IUDs, in particular in the study regions.

Double-Blinded, Randomized, Placebo-Controlled Trial of Multimodal Analgesia at Intrauterine Device Insertion [15I

INTRODUCTION: The utilization of long acting reversible contraception has remained low. Pain and anxiety associated with intrauterine device (IUD) placement are barriers. The purpose of this study was to investigate the effects of cervical lidocaine injections and oral diazepam on pain and anxiety during office IUD insertion. METHODS: Following Institutional Review Board approval, subjects desiring IUD placement were randomized to diazepam 5 mg orally with cervical injections of 2.5 ml of 2% lidocaine or placebo pill with saline injections. Both groups received 800 mg oral Ibuprofen. Providers and subjects were blinded to their assigned group. Primary outcome was pain on a visual analog scale at various steps of IUD insertion. Power analysis set enrollment at 58, which is ongoing. RESULTS: At interim analysis, a total of 41 women have been enrolled. Of these, 39 (20 in the study arm, 19 in the placebo arm) underwent IUD insertion. Median anxiety was significantly decreased when placing the speculum in the study arm compared to placebo (5.5 mm vs. 31 mm; P=.004) respectively. Additionally, subjects in the intervention group reported lower pain scores during insertion of the IUD (24 mm vs. 71 mm, P=.030). CONCLUSION: At interim analysis, oral diazepam and cervical lidocaine injections compared to placebo show clinically significant decreases in anxiety and pain during IUD placement. If these early results are confirmed, the use of cervical lidocaine injections and oral diazepam may provide additional tools to help increase utilization of IUDs by decreasing pain and anxiety associated with insertion.

The Rate of Intrauterine Contraceptive Device Use and Associated Factors Among Married Women of Reproductive Age in Mettu Rural Community, Southwest Ethiopia.

Background: Intrauterine device (IUD) is the second most commonly utilized modern family planning method in the world next to female sterilization. It is the most cost-effective, safe, long-lasting, rapidly reversible method of contraception, but only 2% of married women are using the IUD in Ethiopia. Objective: To assess the rate of IUD use and associated factors among married reproductive age women in Mettu rural community, Southwest Ethiopia. Methods: A community-based cross-sectional study was done among 501 married reproductive age women in Mettu rural district, Southwest Ethiopia from April to May 2018. Data were collected by using an interviewer-administrated questionnaire. Bivariate and multiple variable logistic regression analysis were employed. Results: Twenty-one (4.1%) women were currently using the IUD. Women’s primary education, adjusted odds ratio (AOR) 4.40 (95% C.I 1.32-14.64); secondary and above education, AOR 5.05 (95% C.I 1.11-22.01); having favorable attitudes, AOR 3.24 (95% C.I 1.06-9.89); absence of myth and misconception, AOR 3.40 (95% C.I 1.23-9. 39); having discussion about IUD with women health development army, AOR 3.11 (95% C.I 1.02-9.49); and possessing more than 2 children AOR 3.48 (95% C.I 1.31-9.27) were positively associated with IUD utilization. Conclusion: Only 1 in 25 women was using an IUD. Sociodemographic factors (education and number of children) and behavioral factors (attitudes, myths, and misconceptions) were found to be significant predictors. Scientific community should explore the local contexts of intrauterine use in different parts of Ethiopia.

Intracesarean insertion of the Copper T380A versus 6 weeks postcesarean: a randomized clinical trial

ObjectivesTo compare rates of Copper T380A intrauterine device (IUD) utilization and satisfaction with immediate versus delayed IUD insertion after cesarean delivery in Kampala, Uganda. MethodsThis study was a randomized clinical trial of women undergoing cesarean section who desired an IUD in Kampala, Uganda. Participants were randomly assigned to IUD insertion at the time of cesarean delivery or 6weeks afterward. The primary outcome was IUD utilization at 6months after delivery. ResultsAmong 68 women who underwent randomization, an IUD was inserted in 100% (34/34) of the women in the immediate insertion group and in 53% (18/34) in the delayed group. IUD use at 6 months was higher in the immediate insertion group (93% vs. 50% after delayed insertion; p<.0001). Infection and expulsion were rare and did not differ between groups. When we pooled both groups and looked at IUD users compared to nonusers, 91% (39/43) of IUD users were satisfied or very satisfied with their contraceptive method compared to 44% (11/25) of nonusers (p<.0001). Women who chose not to be in the study or had the IUD removed often did so because of perceived husband or community disapproval. ConclusionThe 6-month utilization of an IUD after immediate insertion was significantly higher than after delayed insertion without increased complications. Contraceptive satisfaction was significantly higher among IUD users than nonusers. Community and husband attitudes influence IUD utilization and continuation in Kampala, Uganda. ImplicationsThis work is important because it shows the safety and efficacy of providing IUDs during cesarean section in a setting where access to any healthcare, including contraception, can be extremely limited outside of childbearing and the consequences of an unintended, closely spaced pregnancy after a cesarean section can be life threatening.

Utilization of Cu-T in Paschim Midnapur district of West Bengal, India: An appraisal

As a part of its commitment towards provision of quality spacing services in family planning, the Government of India introduced Cu-T 380A in 2002 with an effective protection for 10 years replacing the earlier Cu-T 200B. In India, the use of the intrauterine device (IUD) is very low among married women of reproductive age, despite the fact that the Government offers IUD (Cu-T) services free of cost. The aim of the study was to assess the current status of intrauterine contraceptive device (Copper-T) utilization and to determine the relevant factors influencing utilization by currently married women of the reproductive age. The community-based cross-sectional study was carried out in 3 Blocks and 2 Municipality areas of the West Midnapur district in West Bengal. A multistage random sampling method was carried out to select villages of sub-center areas and wards from Municipality areas. A total of 16 areas were selected for the purpose of the study; 125 eligible couples from each selected area were interviewed by a house-to-house survey in order to cover 2000 eligible couples throughout the district. Only females were the respondents. It was found that 67.4% of the couples admitted to the use of any method of contraception. The Couple Protection Rate (by modern method) was found to be 62.6% in the study area. However, it was demonstrated that Cu-T acceptance rate was only 1.3%. Ligation (38.8 %) contributed the highest – other methods included: oral contraceptive pill (19.4%), condom (3%), vasectomy (0.1%) and others (4.8%). The ever use rate of intrauterine contraceptive device (Cu-T/loop) in the study area was 6.2%, which increased significantly with the advancement of maternal age, but no association was found with literacy status of the respondents. Lack of motivation (48.4%), misconception (14%), unawareness (11.3%) unwillingness (9.3%) and religious/cultural barrier (2.4%) were the major factors for underutilization/non-utilization as elicited from the present study. Advocacy through mass media and sustenance of behavior change communication also needed for higher IUD utilization in both rural and urban area. DOI: http://dx.doi.org/10.3329/seajph.v3i2.20036 South East Asian Journal of Public Health Vol.3(2) 2013: 30-34

Barriers to Intrauterine Device Use at an University-Based Women’s Clinic

Objective: The purpose of this study was to determine the barriers to intrauterine device (IUD) use at a University-Based Women’s Clinic. Methods: This study is a cross-sectional survey of a convenience sample of subjects receiving obstetrical care at a University-Based Women’s Clinic. Eligible women who consented to participate self-administered a 16-question survey during a routine prenatal visit. Descriptive statistics were used to report participants’ demographics and history of contraception use. Additionally, subjects were asked if they would consider IUD use in the future. Results: A total of 160 women participated in this study. The average age of this sample was 24.9 (SD = 6.3). The majority were in low income and low education categories. Only 5% of women reported previous IUD use. 27% of women surveyed desired more information regarding IUD contraception. 19% of participants would consider using an IUD in the future and 25% would consider IUD in the future if they knew more about them. Insurance and financial constraints were cited as barriers to IUD use. 4% of the sample reported that they had used an IUD previously and were unhappy with it due to pain and discomfort. 18% would not consider an IUD because they had heard about side effects. 68% of the surveyed sample reported unintended pregnancies. Conclusion: The two most common barriers to IUD use in this patient population was lack of knowledge and concern about side effects. Increasing patients’ knowledge of IUDs has the potential to increase IUD utilization in this clinic population which reported a 68% rate of unintended pregnancy.

The impact of out-of-pocket expense on IUD utilization among women with private insurance

Background The study was conducted to evaluate the impact of out-of-pocket expense on intrauterine device (IUD) utilization among women with private insurance. Study Design We reviewed the records of all women with private insurance who requested an IUD for contraception from an urban academic gynecology practice from May 2007 through April 2008. For each patient, we determined the out-of-pocket expense that would be incurred and whether she ultimately had an IUD placed. The total charge for placement of a copper or levonorgestrel IUD (including the device) was $815. Results Ninety-five women requested an IUD during the study period. The distribution of out-of-pocket expense was bimodal: less than $50 for 35 (37%) women and greater than $500 for 52 (55%) women. Intrauterine device insertion occurred in 24 (25%) women, 19 of whom had an out-of-pocket expense less than $50. In univariate and multivariable analysis, women with insurance coverage that resulted in less than $50 out-of-pocket expense for the IUD were more likely to have an IUD placed than women required to pay $50 or more (adjusted odds ratio=11.4, 95% confidence interval=3.6–36.6). Conclusions Women requesting an IUD for contraception are significantly more likely to have an IUD placed when out-of-pocket expense is less than $50.

The impact of insurance coverage on IUD utilization

To evaluate the impact of insurance coverage on intrauterine device (IUD) utilization in an urban population in a state without mandatory contraceptive insurance coverage.