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01-09-2017

Motivations for Interest, Disinterest and Uncertainty in Intrauterine Device Use Among Young Women

Authors: Anu Manchikanti Gomez, Bridget Freihart

Published in: Maternal and Child Health Journal | Issue 9/2017

Abstract

Objective To elucidate salient contraceptive preferences and priorities as they relate to young women’s interest or lack thereof in intrauterine device (IUD) use. Methods Qualitative data were drawn from a 2012 survey on contraceptive preferences and IUD interest. Among 413 young (ages 18–29) women, open-ended responses describing reasons for interest, disinterest or uncertainty in future IUD use were examined using a thematic analysis approach. Results Most participants were unsure about (49.2%) or not interested in (30.0%) future IUD use. Themes regarding IUD interest related to specific facets of IUD use (e.g., risks and side effects, ease of use), as well as broader influences on contraceptive decision-making (e.g., social influences, alignment with pregnancy intentions). For interested participants, a sense of empowerment pervaded the responses, with many references to the ease of use and lack of requisite maintenance. Uninterested participants were concerned about the internal nature of the IUD, with many describing “horror stories” and fears that the IUD would cause injury or infertility. Unsure participants provided more detailed and complex responses, carefully weighing the advantages and disadvantages of IUD use. Uncertainty was often driven by an acknowledged need for specific information, rather than overall lack of knowledge. Conclusions for Practice In this analysis, many women had a clear sense of their contraceptive preferences, which frequently did not align with IUDs. While continuing to remove barriers to IUD access is critical, patient-centered counseling approaches offer the opportunity to support women in best matching with a method that aligns with their preferences.

Bauermeister, J. A., Pingel, E., Zimmerman, M., Couper, M., Carballo-Diéguez, A., & Strecher, V. J. (2012). Data quality in HIV/AIDS web-based surveys: Handling invalid and suspicious data. Field Methods, 24(3), 272–291.CrossRefPubMedPubMedCentral

Bearak, J. M., Finer, L. B., Jerman, J., & Kavanaugh, M. L. (2016). Changes in out-of-pocket costs for hormonal IUDs after implementation of the Affordable Care Act: An analysis of insurance benefit inquiries. Contraception, 93(2), 139–144.CrossRefPubMed

Beeson, T., Wood, S., Bruen, B., Goldberg, D. G., Mead, H., & Rosenbaum, S. (2014). Accessibility of long acting reversible contraceptives (LARC) in Federally-Qualified Health Centers (FQHCs). Contraception, 89(2), 91–96.CrossRefPubMed

Bergin, A., Tristan, S., Terplan, M., Gilliam, M. L., & Whitaker, A. K. (2012). A missed opportunity for care: two-visit IUD insertion protocols inhibit placement. Contraception, 86(6), 694–697.CrossRefPubMed

Burns, B., Grindlay, K., & Dennis, A. (2015). Women’s awareness of, interest in, and experiences with long-acting reversible and permanent contraception. Women’s Health Issues, 25(3), 224–231.CrossRefPubMed

Carlin, C. S., Fertig, A. R., & Dowd, B. E. (2016). Affordable Care Act’s mandate eliminating contraceptive cost sharing influenced choices of women with employer coverage. Health Affairs, 35(9), 1608–1615.CrossRefPubMed

Chuang, C. H., Mitchell, J. L., Velott, D. L., et al. (2015). Women’s awareness of their contraceptive benefits under the Patient Protection and Affordable Care Act. American Journal of Public Health, 105(S5), 713–715.CrossRef

Durante, J. C., & Woodhams, E. J. (2015). Patient education about the ACA contraceptive coverage requirement increases interest in long-acting reversible contraceptive use. Contraception, 92(4), 375.CrossRef

Dehlendorf, C., Fox, E., Sobel, L., Borrero, S. (2016). Patient-centered contraceptive counseling: Evidence to inform practice. Current Obstetrics and Gynecology Reports 5, 1–9.CrossRef

Finer, L. B., Jerman, J., & Kavanaugh, M. L. (2012). Changes in use of long-acting contraceptive methods in the United States, 2007–2009. Fertility and Sterility, 98(4), 893–987.CrossRefPubMedPubMedCentral

Finer, L. B., & Zolna, M. R. (2016). Declines in unintended pregnancy in the United States, 2008–2011. New England Journal of Medicine, 374(9), 843–852.CrossRefPubMedPubMedCentral

Gomez, A. M., Mann E. S., Torres V. (in press). ‘It would have control over me instead of me having control’: Intrauterine devices and the meaning of reproductive freedom. Critical Public Health. doi:10.1080/09581596.2017.1343935.

Gomez, A. M., & Clark, J. B. (2014). The relationship between contraceptive features preferred by young women and interest in IUDs: An exploratory analysis. Perspectives on Sexual and Reproductive Health, 46(3), 157–163.CrossRefPubMed

Gomez, A. M., Fuentes, L., & Allina, A. (2014). Women or LARC first? Reproductive autonomy and the promotion of long-acting reversible contraceptive methods. Perspectives on Sexual and Reproductive Health, 46(3), 171–175.CrossRefPubMedPubMedCentral

Gomez, A. M., Hartofelis, E. C., Finlayson, S., & Clark, J. B. (2015). Do knowledge and attitudes regarding intrauterine devices predict interest in their use? Women’s Health Issues, 25(4), 359–365.CrossRefPubMed

Gubrium, A. C., Mann, E. S., Borrero, S., et al. (2016). Realizing reproductive health equity needs more than long-acting reversible contraception (LARC). American Journal of Public Health 106, 18–19.CrossRefPubMed

Hall, K. S., Ela, E., Zochowski, M. K., et al. (2016). “I don’t know enough to feel comfortable using them:” Women’s knowledge of and perceived barriers to long-acting reversible contraceptives on a college campus. Contraception, 93(6), 556–564.CrossRefPubMedPubMedCentral

Jackson, A. V., Karasek, D., Dehlendorf, C., & Foster, D. G. (2016). Racial and ethnic differences in women’s preferences for features of contraceptive methods. Contraception, 93(5), 406–411.CrossRefPubMed

Kavanaugh, M. L., Jerman, J., & Finer, L. B. (2015). Changes in use of long-acting reversible contraceptive methods among U.S. women, 2009–2012. Obstetrics & Gynecology, 126(5), 917–927.CrossRef

Kaye, K., Suellentrop, K., & Sloup, C. (2009). The fog zone: How misperceptions, magical thinking, and ambivalence put young adults at risk for unplanned pregnancy. Washington, D.C.: National Campaign to Prevent Teen and Unplanned Pregnancy.

Kohn, J. E., Hacker, J. G., Rousselle, M. A., & Gold, M. (2012). Knowledge and likelihood to recommend intrauterine devices for adolescents among school-based health center providers. Journal of Adolescent Health, 51(4), 319–324.CrossRefPubMed

Lopez, L., Ramos, D. E. (2015). Understanding acceptance of contraception method preference among African American mothers receiving Medicaid in Los Angeles County [247]. Obstetrics & Gynecology. 125, 80S.CrossRef

Moreau, C., Cleland, K., & Trussell, J. (2007). Contraceptive discontinuation attributed to method dissatisfaction in the United States. Contraception, 76(4), 267–272.CrossRefPubMed

Mosher, W. D., Moreau, C., Lantos, H. (2016) Trends and determinants of IUD use in the USA, 2002–2012. Human Reproduction. 31, 1696–1702.CrossRefPubMed

Pace, L. E., Dusetzina, S. B., & Keating, N. L. (2016). Early impact of the Affordable Care Act on uptake of long-acting reversible contraceptive methods. Medical Care, 54(9), 811–817.CrossRefPubMed

Patton, M. Q. (2001). Qualitative research and evaluation methods (3rd edn.). Thousand Oaks, CA: Sage Publications.

Potter, J., Rubin, S. E., & Sherman, P. (2014a). Fear of intrauterine contraception among adolescents in New York City. Contraception, 89(5), 446–450.CrossRefPubMedPubMedCentral

Potter, J. E., Hopkins, K., Aiken, A. R., et al. (2014b). Unmet demand for highly effective postpartum contraception in Texas. Contraception, 90(5), 488–495.CrossRefPubMedPubMedCentral

Tyler, C. P., Whiteman, M. K., Zapata, L. B., Curtis, K. M., Hillis, S. D., & Marchbanks, P. A. (2012). Health care provider attitudes and practices related to intrauterine devices for nulliparous women. Obstetrics and Gynecology, 119(4), 762–771.CrossRefPubMed

Title: Motivations for Interest, Disinterest and Uncertainty in Intrauterine Device Use Among Young Women
Authors: Anu Manchikanti Gomez
Bridget Freihart
Publication date: 01-09-2017
Publisher: Springer US
Published in: Maternal and Child Health Journal / Issue 9/2017
Print ISSN: 1092-7875
Electronic ISSN: 1573-6628
DOI: https://doi.org/10.1007/s10995-017-2297-9

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