Interest in and Experience with Intrauterine Device Self-Removal Among Current and Past Intrauterine Device Users in...

We sought to assess current and former intrauterine device (IUD) users' interest in and experiences with IUD self-removal and to examine associations between participant characteristics, past experiences with removal, and future interest in self-removal.

We conducted a cross-sectional follow-up survey of HER Salt Lake participants who had ever used an IUD and consented to follow-up. Participants completed an electronic survey assessing interest in receiving self-removal information, past self-removal attempts and outcomes, and experiences with provider removal. We used descriptive statistics and χ² tests to explore self-removal interest and experiences, and differences in interest by characteristics and past removal experiences.

More than one-half of the 621 participants (57%) expressed an interest in IUD self-removal. Among current IUD users, 49% reported willingness to try self-removal. One in 10 participants had attempted self-removal; 68% were successful and most (61%) reported no problems. Among those who attempted self-removal, the most commonly reported problems were experiencing more pain than they felt comfortable with (21%) and being unable to feel their IUD strings (9%). Participants who expressed interest in self-removal were more likely to report prior barriers to provider removal, including cost, scheduling delays, discomfort with care, or distrust of the health care system. Those interested were also more often parous participants, current IUD users, those not married or cohabitating with their partners, and those who did not identify as heterosexual.

In our sample, interest in self-removal was high, and most participants who had attempted self-removal did so successfully and without problems. Providing accessible information about self-removal in preferred formats may help to reduce barriers to IUD discontinuation and support reproductive autonomy.