Insertion of Lippes loop by nurse-midwives and doctors

Area of Science:

• Reproductive Health
• Family Planning
• Obstetrics and Gynecology

Background:

• Intrauterine devices (IUDs) are a common form of reversible contraception.
• The role of healthcare extenders in IUD insertion is a key consideration for expanding access.
• Previous studies have explored variations in IUD outcomes based on provider type.

Purpose of the Study:

• To compare the safety and efficacy of Lippes loop insertion by doctors versus nurse-midwives.
• To evaluate pregnancy and expulsion rates associated with different healthcare providers.
• To assess the viability of paramedical personnel performing IUD insertions.

Main Methods:

• Follow-up study involving 1000 women in Barbados over 7 to 19 months.
• Two groups of 500 women each: one group received Lippes loops inserted by doctors, the other by nurse-midwives.
• Comparison of pregnancy incidence and loop expulsion rates between the two groups.

Main Results:

• A slightly higher incidence of pregnancy was observed in the group where nurse-midwives inserted the Lippes loops.
• The rate of loop expulsion was also slightly higher in the nurse-midwife group.
• These differences between the groups were not statistically significant.

Conclusions:

• Insertion of Lippes loops by paramedical personnel, such as nurse-midwives, is not contraindicated.
• Adequate training for paramedical staff is essential for safe and effective IUD insertion.
• Paramedical insertion can be a viable option when economic necessity dictates, supporting broader contraceptive access.