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  • Title: Today's IUDs offer safe, effective contraception.
    Author: Finger WR.
    Journal: Netw Res Triangle Park N C; 1993 Mar; 13(3):12-5. PubMed ID: 12318094.
    Abstract:
    Even though IUDs are safe and effective when correctly inserted in women in monogamous relationships, both providers and users hold misperceptions about the safety of IUD, thereby restricting womens access to IUDs. Such practices include providers requiring numerous follow-up pelvic examinations and restrictions on who may insert IUDs. Yet research shows that follow-up pelvic examinations are not cost effective and do not necessarily improve the quality of care. Instead, providers should inform women of what symptoms and side effects warrant a follow-up examination, (e.g. irregular or excessive bleeding). Nurses, midwives, assistant midwives as well as physicians who have undergone competency-based training, including 10 to 15 correct insertions under supervision, can safely insert IUDs. Still, some countries restrict IUD insertions to just physicians, e.g., Egypt. On the other hand, midwives and assistant midwives can insert IUDs in Indonesia. The leading medical barrier is the belief that IUDs increase the risk of pelvic inflammatory disease (PID), especially in countries where IUD use is low. Providers inserted the first generation of IUDs in women at high risk of sexually transmitted diseases (STD); thus, many people attributed PID to the IUD rather than to the STDs. Studies showing an association between the Dalkon Shield and PID also fueled the fear. Research indicates that women are at an increased risk of PID, only during the first 4 to 6 weeks after IUD insertion, but thereafter no risk exists for women in monogamous relationships. Other obstacles are cost (e.g., US private physicians, US $1609-400), no promotional campaigns to improve the image of the IUD, and rumors (e.g., IUD migrates to the stomach or heart). Today most providers insert the copper-releasing IUDs, the second generation IUDs.
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