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Developing an intrauterine device self-removal guide: a mixed methods qualitative and small pilot study.

Francesca Collins1, Kelly Gilmore2, Kelsey A Petrie3

  • 1University of Washington School of Public Health, 1959 NE Pacific Street Seattle, Seattle, WA, 98195, USA.

Contraception and Reproductive Medicine
|June 30, 2022
PubMed
Summary

This study developed a guide for intrauterine device (IUD) self-removal to empower users. While experts found IUD self-removal safe, a pilot showed most users couldn't remove their IUD with the guide.

Keywords:
IUD self-removal guide

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Area of Science:

  • Reproductive Health
  • Contraception Technology
  • Patient Empowerment

Background:

  • Intrauterine devices (IUDs) are highly effective long-acting reversible contraception (LARC).
  • Users face barriers to IUD removal, impacting autonomy.
  • IUD self-removal offers a potential solution to mitigate removal obstacles.

Purpose of the Study:

  • To develop a user-centered guide for self-removal of intrauterine devices (IUDs).
  • To enhance user control over their contraception method.
  • To assess the feasibility and acceptability of an IUD self-removal guide.

Main Methods:

  • Two-phase mixed-methods study: qualitative analysis and pilot testing.
  • Online content analysis and expert interviews informed guide development.
  • Focus groups and interviews with IUD users refined the guide; pilot tested on eight users.

Main Results:

  • Experts deemed IUD self-removal safe with low risk.
  • Key factors for success include palpable strings, specific positioning, and multiple attempts.
  • Pilot participants suggested improvements for non-palpable strings; one user successfully removed their IUD.

Conclusions:

  • The developed IUD self-removal guide received user satisfaction.
  • The majority of participants in the small pilot were unsuccessful in self-removal.
  • Further research is necessary to evaluate the guide's efficacy in increasing successful self-removal rates.