Young women unfamiliar with safety, effectiveness of IUD

Rochester study points to need for contraceptive counseling after first pregnancy

The IUD might be one of the best-kept birth control secrets for young women, according to researchers at the University of Rochester Medical Center.

Their study, published in this month's journal Obstetrics & Gynecology, revealed that most young women who sought birth control after a first pregnancy were unaware of the safety and effectiveness of modern intrauterine devices (IUD). An IUD is a small T-shaped device that is inserted into the uterus by a health care provider. It provides long-term birth control by preventing sperm from fertilizing eggs.

"Modern IUDs are safe, effective, and reversible, but only about 2 percent of U.S. women use them," said Nancy L. Stanwood, M.D., M.P.H., assistant professor of Obstetrics and Gynecology at the University of Rochester Medical Center. Suspecting the low use of IUDs was related to awareness, Stanwood's study aimed to estimate knowledge of IUDs among young pregnant women.

In the study, nearly 200 pregnant women, ages 14 to 25, were asked about their contraceptive history, plans, and knowledge. They were also asked if they had heard of IUDs, and if they knew anything about them. Half of the women in the study said they had heard of IUDs, but 71 percent were unaware of their safety and 58 percent did not know about their effectiveness in preventing pregnancy.

"Those results have significant implications, especially when you consider that only 9 percent of the women surveyed had planned their current pregnancy," Stanwood said. "More than half said they wanted to wait at least four years before becoming pregnant again, and more than a quarter said they never wanted to be pregnant again."

Though not widely used in the U.S., today's IUDs have been proven to be highly effective in preventing pregnancy and are also quite safe, Stanwood said. Modern IUDs have failure rates similar to tubal ligation, but are not permanent and do not require surgery.

Pregnancy rates for women using IUDs are 0.1% in the first year and are 2 percent over a total of 10 years. Compared to other more popular methods, pregnancy rates for condom users are 14 percent in the first year with typical use and 3 percent with perfect use. For birth control pills, the rate is 3 to 8 percent in the first year with typical use and 0.1 percent with perfect use.

"Young women choosing contraception after a pregnancy would benefit from counseling about the relative safety and effectiveness of IUDs, allowing them to make fully informed contraceptive decisions," Stanwood said.

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Last reviewed: By John M. Grohol, Psy.D. on 21 Feb 2009
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