Clinical availability of the copper IUD in rural versus urban settings: A simulated patient study

Abstract

Objective To assess the proportion of Washington state clinics that offer the copper IUD in rural vs urban settings. Study design We employed a simulated patient model to survey clinics in the Human Health Resources and Services Administration 340B database to primarily assess the availability of the copper IUD. Results We successfully surveyed 194/212 (92%) clinics. More urban than rural clinics reported copper IUD availability (76/97 [78%] vs 49/97 [51%]; p < 0.01). Conclusions Rural clinics are less likely than urban clinics to have the copper IUD available. Implications The frequency of unintended pregnancies is high in the United States. We should focus our attention on decreasing barriers to the copper IUD as a long-acting reversible contraceptive, particularly for women living in rural settings.