Acceptability of the copper intrauterine device as a form of emergency contraception in New South Wales, Australia

Abstract

Background: The copper-intrauterine device (Cu-IUD) is the most effective emergency contraception (EC), and the only method providing ongoing contraception; however, it is underutilised in Australia.

Methods: An online cross-sectional survey of clients and clinicians at a family planning service was undertaken. Clients aged 16–55 and identifying as female or transgender male were eligible. The survey explored previous experience with and knowledge of the Cu-IUD as EC among clients, current EC practices among clinicians, and barriers and enablers among clients and clinicians.

Results: Of 470 clients, 64.5% had previously used EC. Only 12.7% knew the Cu-IUD was a form of EC and 2% had used it. When given information on effectiveness, side-effects and costs, 46.8% reported they would consider the Cu-IUD for EC. However, 40% viewed cost and possible side-effects as barriers. Of the 58 clinicians surveyed, 55% reported discussing Cu-IUD as EC with clients versus 94% discussing oral EC, with time pressures reported as the main barrier.

Conclusion: Low awareness among clients, and limited discussion by clinicians, highlights a need for increased education and promotion strategies for the Cu-IUD as EC. With greater knowledge, demand for this option may increase. This will require processes to ensure timely access to insertions.

摘要

背景：带铜宫内节育器（Cu-IUD）是最有效的紧急避孕（EC）, 且是持续避孕的唯一方法；然而, 在澳大利亚带铜宫内节育器并未得到充分使用。

方法：对计划生育机构的顾客和临床医生进行一项线上的横断面调查。纳入16-55岁的女性或变性男性。调查了顾客对于带铜宫内节育器作为EC的使用和了解情况、临床医生对目前EC方法的了解、阻碍和促使顾客和医生使用带铜宫内节育器的原因。

结果：470位顾客中, 64.5%的顾客之前采用过EC。仅有12.7%的顾客知道Cu-IUD是一种紧急避孕方式, 2%的顾客使用过这种方式。当告知顾客Cu-IUD的有效性、副反应和花费后, 46.8%的顾客表示愿意考虑Cu-IUD作为紧急避孕的方式。然而, 40%的顾客认为花费和可能的副反应是使用Cu-IUD的阻碍因素。调查的58位医生中, 55%的医生与顾客讨论将Cu-IUD作为EC, 94%的医生与顾客讨论口服紧急避孕药。时间压力是主要的阻碍因素。

结论：顾客的不了解, 临床医生有限的讨论使得Cu-IUD做为EC需要更多的教育和推广策略。随着更多的了解, 对Cu-IUD的需求可能会增加。这将需要流程来确保能有足够的时间植入Cu-IUD

Keywords:

• Emergency contraception
• copper intrauterine device
• contraceptive knowledge
• Australia

Disclosure statement

The Family Planning NSW (FPNSW) Research Centre leads and collaborates in a number of investigator-initiated and competitive contraceptive studies, several of which receive funding from industry partners. FPNSW also provides sexual and reproductive health clinical services and delivers contraception education and training to health professionals. FPNSW has received funding to provide training in insertion of the contraceptive implant and the LNG-IUD, and sponsorship to provide education to healthcare professionals. No external funding was received for this research.

Notes

1 For simplicity of language we use the terms women/female in this paper, however this should be taken to also include people who do not identify as female.

2 Due to the way the survey was set up, whilst only clients aged 16-49 years were invited to participate, the survey was open to the ages of 16-55 years.

3 Australian Government scheme that provides subsidised prescription medication.

4 Health services subsidised by the Australian government.