Myths and misconceptions about intrauterine contraception among women seeking termination of pregnancy

Abstract

Background Immediate initiation of an intrauterine device (IUD) or intrauterine system (IUS) following termination of pregnancy (TOP) is associated with a significant reduction in the risk of another TOP. In spite of its high efficacy, uptake of intrauterine contraception in the UK is low. Myths and misconceptions about the method may contribute to the low uptake. Study design Anonymous, self-administered questionnaire among women requesting a TOP in a hospital abortion service in Scotland, UK. Methods Misconceptions about intrauterine contraception were extracted from an online social networking and micro-blogging service, and from existing research to develop a questionnaire containing 12 negative statements about intrauterine contraception. Respondents indicated their level of agreement with each statement. Results A total of 106/125 (85%) women requesting a TOP completed the questionnaire. The two commonest negative statements that respondents agreed with were that the IUD/IUS 'Is painful to have inserted' (n=36; 34%) and that 'It can move around inside your body' (n=25; 23.6%). The range of women who neither agreed nor disagreed with negative statements was 26.4-56.0%. Twenty-seven (25%) women indicated that the IUD/IUS was their planned method of post-TOP contraception.Conclusions Although myths about intrauterine contraception persist among a small proportion of women requesting a TOP, lack of knowledge about the method is also evident. The consultation prior to TOP is an important opportunity to provide accurate and quality information to women about the IUD/IUS that may serve to increase uptake and prevent repeat abortions.

Conceptions of Contraceptive Use in Rural KwaZulu-Natal, South Africa: Lessons for Programming

“…Thus, government intervention is confined to providing incentives that influence beliefs, traditions and behaviours concerning fertility desires; as well as opportunities that enhance an individual’s self-fulfilment [1,6,19,20,23,24,25,26,27]. …”

“I think maybe 10 years seems a bit long.” Beliefs and attitudes of women who had never used intrauterine contraception

“…This research presents a complex picture of the concerns of never-users regarding IUC, and adds significantly to a body of knowledge about the influence of adverse accounts of IUC from other people;6 7 14 16 17 concerns about the risks and side effects of IUC;6–14 16 17 and about painful fitting and unpleasant removal,6–8 10–14 fears about the device moving,10 and being viewed as a foreign body over which the user has no control 11 33. The mixed-method design allowed us to indicate the extent to which views expressed in qualitative interviews reflect attitudes in a larger sample, and it is notable how persistent these concerns are in the population over time, despite efforts to provide objective and reassuring information about IUC.…”

Use of IUDs for emergency contraception: current perspectives

“…In a study of women seeking termination of pregnancy in Scotland, 90% had an unintended pregnancy but only 11.8% had used emergency contraception. 40 A range of studies from different services in the UK show wide variability in the uptake of the different methods of emergency contraception, particularly the copper IUD. In a specialist Contraception and Sexual Health (CASH) service in Edinburgh, 34 only 2% of the women attending for emergency contraception accepted an IUD, compared to 5% in Liverpool 40 and 15% in Cambridge.…”

“…40 A range of studies from different services in the UK show wide variability in the uptake of the different methods of emergency contraception, particularly the copper IUD. In a specialist Contraception and Sexual Health (CASH) service in Edinburgh, 34 only 2% of the women attending for emergency contraception accepted an IUD, compared to 5% in Liverpool 40 and 15% in Cambridge. 43 The FSRH guidance advocated that all eligible women should be offered an IUD, which should be fitted on the day of presentation if possible.…”

“…44 Even with hormonal methods of emergency contraception, qualitative studies 42 have demonstrated that women have concerns and believe myths about harmful hormonal load and effects on future fertility. Similarly, in a qualitative study 40 exploring women's attitudes to intrauterine contraception among women seeking termination of pregnancy, 34% agreed with the statement that insertion was painful (especially women under the age of 19 years); 23.6% considered that it could move around inside the body; and 16% felt there was a good chance of damage to the womb and creation of a breeding ground for infection. Familiarity with a method and what is perceived as normal (eg, using the pill as opposed to an IUD) encourages use of that method, and the negative experiences of peers and relatives, even those heard secondhand, contribute to negative perceptions.…”