Intrauterine contraception: a literature review investigating the barriers limiting use and Canadian women
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Date
2020
Authors
Houston, Michelle
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Abstract
Intro: Intrauterine contraceptive devices (IUCDs) are highly effective and are recommended as first line contraceptives for women. Very few Canadian women use these forms of contraception, even fewer youths use these methods. The goal of this paper is to review relevant literature in order to identify and investigate the barriers preventing the more widespread use of IUCDs by Canadian women. Emphasis is placed on at risk groups, in order to make recommendations to increase uptake of the same, with the aim of decreasing unintended pregnancies. Methods: An online literature review of relevant papers pertaining to information on IUCDs, healthcare system, patient and provider barriers between 2000 and 2020 was conducted with a preference on Canadian papers. Results: Barriers can be broadly broken down into 3 categories: healthcare system, patient and practitioner based. Evidence suggests that there is an overall lack of awareness and limited knowledge regarding IUCDs among the public, provider misconceptions and lack of confidence in insertion capabilities, high up front cost, and systemic issues pertaining to limited access to contraceptive providers. Studies have shown that evidence based education and removal of cost and access related barriers increases patient acceptance of and adherence to IUCDs. Conclusion: In order to increase the use of IUCDs by Canadian women, large scale subsidy and policies are required to create programmes targeted at improving public and provider education
and awareness. Additionally, increased hands on training and task sharing with allied providers is necessary to increase patient access and timely availability of these highly effective contraceptives.
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Keywords
intrauterine contraceptive devices