Jennifer R Amico1, Samantha Stimmel2, Shawna Hudson2, Marji Gold3. 1. Department of Family Medicine and Community Health, Rutgers Robert Wood Johnson Medical School, United States. Electronic address: jennifer.amico@rutgers.edu. 2. Department of Family Medicine and Community Health, Rutgers Robert Wood Johnson Medical School, United States. 3. Department of Family and Social Medicine, Albert Einstein College of Medicine, Montefiore Medical Center, United States.
Abstract
OBJECTIVE: The perspectives and experiences of intrauterine device (IUD) users who consider IUD self-removal are largely unknown. This study describes the reasons for IUD self-removal as documented in internet forums by IUD users discussing self-removal. STUDY DESIGN: This qualitative study used an internet search strategy to document IUD users' reasons for self-removal in the United States. We employed a content analysis of online data using inductive and deductive qualitative techniques to examine the reasons why IUD users consider self-removal. RESULTS: Search results initially identified 235 websites, of which 28 had online health or parenting forums with content related to IUD self-removal. Individual websites contained between 1 and 637 posts by between 1 and 454 individual users. IUD users described a variety of reasons for IUD discontinuation including undesired symptoms or side effects as well as planning for pregnancy. IUD users discussed difficulties accessing provider-removal because of cost or lack of appointment availability. IUD users also discussed how reading about others' successful self-removal experiences or approval by medical providers made self-removal a feasible or acceptable option. CONCLUSIONS: Some IUD users utilize online forums for advice about IUD removal, and attempt IUD self-removal due to side effects or because they desire pregnancy. Lack of access to a provider led some patients to attempt self-removal who may have preferred provider-removal. IMPLICATIONS: For those who prefer self-removal, anticipatory counseling from a clinician regarding self-removal might be useful and reassuring. Improving access to self-removal may help preserve reproductive autonomy for those who face barriers to IUD removal in the clinical setting.
OBJECTIVE: The perspectives and experiences of intrauterine device (IUD) users who consider IUD self-removal are largely unknown. This study describes the reasons for IUD self-removal as documented in internet forums by IUD users discussing self-removal. STUDY DESIGN: This qualitative study used an internet search strategy to document IUD users' reasons for self-removal in the United States. We employed a content analysis of online data using inductive and deductive qualitative techniques to examine the reasons why IUD users consider self-removal. RESULTS: Search results initially identified 235 websites, of which 28 had online health or parenting forums with content related to IUD self-removal. Individual websites contained between 1 and 637 posts by between 1 and 454 individual users. IUD users described a variety of reasons for IUD discontinuation including undesired symptoms or side effects as well as planning for pregnancy. IUD users discussed difficulties accessing provider-removal because of cost or lack of appointment availability. IUD users also discussed how reading about others' successful self-removal experiences or approval by medical providers made self-removal a feasible or acceptable option. CONCLUSIONS: Some IUD users utilize online forums for advice about IUD removal, and attempt IUD self-removal due to side effects or because they desire pregnancy. Lack of access to a provider led some patients to attempt self-removal who may have preferred provider-removal. IMPLICATIONS: For those who prefer self-removal, anticipatory counseling from a clinician regarding self-removal might be useful and reassuring. Improving access to self-removal may help preserve reproductive autonomy for those who face barriers to IUD removal in the clinical setting.
Authors: Alice F Cartwright; Amelia C L Mackenzie; Rebecca L Callahan; M Valeria Bahamondes; Laneta J Dorflinger Journal: Front Glob Womens Health Date: 2022-09-07