A qualitative exploration of emergency contraception users' willingness to select the copper IUD

Abstract

Background The copper T intrauterine device (IUD) is an effective but underutilized method of emergency contraception (EC). This study investigates the factors influencing a woman's decision around which method of EC to select. Study Design In-depth interviews with 14 IUD and 14 oral EC users aged 18–30 years accessing public health clinics. Results Emergency contraception users associated long-term methods of contraception with long-term sexual relationships. Women were not aware of the possibility of using the copper IUD for EC. Cost was identified as a major barrier to accessing IUDs. Perceived side effects and impact on future pregnancies further influenced the EC method a participant selected. Conclusions Women think about contraception in the context of each separate relationship and not as a long-term individual plan. Most women were unaware of the copper IUD for EC. Furthermore, there is little discussion between women and their health-care providers around EC.

U.S. Men’s Perceptions and Experiences of Emergency Contraceptives

“…Research demonstrates that little to no method discussion occurs between partners in casual relationships, limiting the use of effective contraception (Raine et al, 2010). Long-term methods of contraception have been reported to be associated with long-term relationships (Wright, Frost, & Turok, 2012). Long-term relationship status may not result in consistent contraceptive use.…”

Do Knowledge and Attitudes Regarding Intrauterine Devices Predict Interest in Their Use?

“…In several studies, young women describe 3 discomfort with the invasiveness of IUDs (Gilliam, Davis, Neustadt, & Levey, 2009;Kavanaugh, Frohwirth, Jerman, Popkin, & Ethier, 2013;Weston, Martins, Neustadt, & Gilliam, 2012) and the lack of user control over the method (Asker, Stokes-Lampard, Wilson, & Beavan, 2006;Dempsey, Billingsley, Savage, & Korte, 2012;Foster, Karasek, Grossman, Darney, & Schwarz, 2012;Gomez, 2014;Kavanaugh et al, 2013). Other research has described women's desire for dual protection against pregnancy and sexually transmitted infections (Whitaker et al, 2008) and concerns about potential side effects (Kavanaugh et al, 2013;Spies, Askelson, Gelman, & Losch, 2010;Whitaker et al, 2008;Wright, Frost, & Turok, 2012). Some young women perceive IUDs as methods more appropriate for older women (Kavanaugh et al, 2013;Spies et al, 2010).…”

The copper intrauterine device for emergency contraception: an opportunity to provide the optimal emergency contraception method and transition to highly effective contraception

“…Other potential barriers identified from US and European studies, in addition to concern over cost, are awareness of the IUD as a method of EC, misconceptions about the IUD and its side effects, especially regarding future fertility, fear of the insertion process and the idea of using a long-acting device [98][99][100]. Women who did not know the IUD could be used for EC were less likely to choose that method.…”

“…Knowing someone who had a good experience with the IUD, having prior personal experience with the IUD, being able to see the device or having accurate knowledge about the IUD side effects, safety and efficacy were more commonly seen in women who chose the IUD for EC [94,99]. The 'long acting' aspect of the IUD was seen as both a benefit and a reason not to use it [99,100]. Women who were in relationships looked more favorably on the duration of effectiveness, while those not in a relationship did not think using a longer acting method was necessary and instead viewed it as a deterrent [100].…”