Women seeking emergency contraception more likely to use IUDs if offered counseling and 'same-day service'

by Andréa Stanford

(Medical Xpress)—Health care clinics should routinely offer same-day placement of intrauterine devices (IUDs) to women seeking emergency contraception, according to researchers at the University of Pittsburgh School of Medicine. The study findings, published online in the journal Contraception, demonstrate that providing patient education along with same-day placement service increases both knowledge and use of IUDs three months and a year after women seek emergency contraception.

"Women seeking emergency contraception, who are at very high risk of undesired pregnancy, deserve clear information about the most effective contraceptives available," explained Eleanor Bimla Schwarz, M.D., M.S., director of the women's health services research unit at the Center for Research on Health Care, Pitt School of Medicine, and lead author of the study.

Dr. Schwarz and colleagues compared knowledge and use of IUDs and contraceptive implants among women seeking at an inner-city clinic eight before and 21 months after it began providing structured counseling and offering same-day IUD or implant placement. A total of 186 women between the ages of 15 and 45 who wanted to avoid pregnancy for at least six months completed surveys immediately and three and 12 months after their clinic visit. Data from the clinic's electronic medical record provided additional information about contraceptive initiation during the course of the study.

Researchers found that after the clinic began offering structured counseling, more women had accurate knowledge of the effectiveness of IUDs and started to use either an IUD or implant. Thus, this change in clinic policy dropped the number of women using no form of contraception from 17 percent to 3 percent. Data obtained from the indicated that when the option of same-day placement was offered, 11 percent of women received a same-day IUD, and according to survey data, of those who received this service, 88 percent and 80 percent reported continued use at a three- and 12-month follow-up, respectively.

"The results of our study demonstrate that we can make 'same-day service with a smile' our standard of care," concluded Dr. Schwarz. "By fully educating our patients about their contraceptive options and providing convenient access to desired services, we empowered to effectively avoid undesired pregnancies."

More information: "Routine counseling about intrauterine contraception for women seeking emergency contraception." E. Bimla Schwarz, Melissa Papic, Sara M. Parisi, Erin Baldauf, Rachel Rapkin, Glenn Updike. Received 19 November 2013; received in revised form 7 February 2014; accepted 13 February 2014. published online 03 March 2014. DOI: 10.1016/j.contraception.2014.02.007

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