Rachel L Wright1, Caren J Frost2, David K Turok3. 1. Department of Social Work, Appalachian State University, Boone, North Carolina. Electronic address: wrightrl@appstate.edu. 2. College of Social Work, University of Utah, Salt Lake City, Utah. 3. Department of Obstetrics and Gynecology, University of Utah, Salt Lake City, Utah.
Abstract
INTRODUCTION: The copper intrauterine device (IUD) is the most effective method of emergency contraception (EC) available for use after unprotected intercourse. Family planning clinics, commonly staffed by advanced practice clinicians, fulfill a significant role in health care and contraceptive service delivery for women in the United States. There are limited data assessing the perspectives and experiences of these providers in using the copper IUD as EC in these settings. METHODS: Semistructured individual interviews were conducted with 12 advanced practice clinicians with experience inserting the copper IUD. A phenomenological approach was used to frame the study and analysis. A modified version of the Van Kaam method of analysis was used to analyze the data from interview transcripts. RESULTS: Participants reported feelings of responsibility to support long-acting and highly effective methods of contraception. Patients' abilities to provide an accurate history of the last instance of unprotected intercourse in relation to their menstrual cycles and fear of painful insertions influenced participants' willingness to offer the copper IUD. This included provider concerns about causing uterine perforation prompting discontinuation of IUD insertion attempts. The participants perceived patients as having little knowledge about the copper IUD in general and as not being committed to using the copper IUD long term. CONCLUSIONS: Numerous factors influenced advanced practice clinicians' decisions to present the copper IUD as a method of EC. Promoting support and sharing practitioner experiences with inserting the copper IUD as EC may increase practitioner comfort with the copper IUD as EC.
INTRODUCTION: The copper intrauterine device (IUD) is the most effective method of emergency contraception (EC) available for use after unprotected intercourse. Family planning clinics, commonly staffed by advanced practice clinicians, fulfill a significant role in health care and contraceptive service delivery for women in the United States. There are limited data assessing the perspectives and experiences of these providers in using the copper IUD as EC in these settings. METHODS: Semistructured individual interviews were conducted with 12 advanced practice clinicians with experience inserting the copper IUD. A phenomenological approach was used to frame the study and analysis. A modified version of the Van Kaam method of analysis was used to analyze the data from interview transcripts. RESULTS:Participants reported feelings of responsibility to support long-acting and highly effective methods of contraception. Patients' abilities to provide an accurate history of the last instance of unprotected intercourse in relation to their menstrual cycles and fear of painful insertions influenced participants' willingness to offer the copper IUD. This included provider concerns about causing uterine perforation prompting discontinuation of IUD insertion attempts. The participants perceived patients as having little knowledge about the copper IUD in general and as not being committed to using the copper IUD long term. CONCLUSIONS: Numerous factors influenced advanced practice clinicians' decisions to present the copper IUD as a method of EC. Promoting support and sharing practitioner experiences with inserting the copper IUD as EC may increase practitioner comfort with the copper IUD as EC.