No abstract

A study was undertaken to look at the clinical behavior of the Dalkon Shield, the Lippes Loop D and the TCu-200 inserted by physicians and midwives. Differences among the three devices were not statistically significant, although lower expulsion rates and higher pregnancy rates were reported for the Dalkon Shield. No differences were observed between insertions performed by physicians and those performed by midwives; this emphasizes the efficiency of using paramedical personnel in the field of intrauterine contraception.

A retrospective study of the association between selected sociopsychological variables and the early discontinuation of intrauterine device use was carried out among patients of the Central Clinic of Family Health, Inc., New Orleans, Louisiana. In toto, 270 women cooperated in a standardized interview which was administered by trained auxiliaries of the clinic's staff; Investigation of sociodemographic characteristics shows a greater proportion of the terminators to be younger, more mobile, and to have experienced more changes in marital partners. Continuers are at greater health risk in pregnancy as rated by the clinic at time of admission, but do not verbalize this as a concern. Responses relating to sexuality image and contraceptive attitudes indicate that a greater proportion of the terminators dislike an internal IUD self string check, hold a more pro-pregnancy attitude, do not feel dependent on the availability of contraceptives, and currently utilize the less effective contraceptive methods. Few significant differences are reported in the side effects experienced after IUD insertion by the terminators or continuers. However, the groups hold decidely different perceptions of the meaning of such complaints. A greater proportion of the terminators perceive themselves as being sick, take to bed during the menses, find that complaints disrupt their normal household activities, and are fearful of the meaning to their health of the difficulties experienced. The majority of both groups are functioning in a segregated marital role pattern. Terminators portray a tendency to be interacting with more "traditional" husbands who visualize the proper role for their wives as mothers whose duty it is to stay home. Continuers, to a greater degree, are more dominant individuals, make more decisions in the running of the home, and feel that contraception is their responsibility alone. Program implications take direction from the findings that the terminator is a more "costly" patient in terms of physician time and is at a decidely greater risk of final closure to all clinic contacts.