Access to IUD removal: Data from a mystery-caller study

Area of Science:

• Reproductive Health
• Healthcare Access
• Women's Health

Background:

• Improving access to intrauterine devices (IUDs) is a current focus in reproductive healthcare.
• Understanding barriers to IUD removal is essential for comprehensive reproductive care and patient autonomy.

Purpose of the Study:

• To assess access and identify barriers to intrauterine device (IUD) removal appointments in 10 mid-sized U.S. cities.
• To evaluate appointment availability, required visits, clinic policies, and out-of-pocket costs for IUD removal.

Main Methods:

• A mystery caller study was conducted, contacting health centers identified through search engines in 10 cities.
• Data collected included appointment timing, pre-removal visit requirements, and out-of-pocket costs.
• Descriptive statistics were used to analyze availability and cost, comparing primary care with family planning/gynecology clinics.

Main Results:

• 60.7% of clinics offered IUD removal, with most providing appointments within 2 weeks (median 10 days).
• 17.3% of clinics required multiple visits, and 5.6% refused to remove IUDs not inserted at their facility.
• Median out-of-pocket cost for IUD removal was $262, with significant variation ($50-$1000+); no cost difference was found between clinic types.

Conclusions:

• While timely IUD removal appointments are often available, financial and clinic policy barriers persist.
• Barriers include the need for multiple appointments and significant out-of-pocket expenses.
• Reducing these barriers is vital to ensure reproductive autonomy and support patient choice regarding IUD use.