Brooke W Bullington, Alexandra Gero, Sarah Elliott, Jami Baayd, Rebecca Simmons, Lori M Gawron, Jessica N Sanders, Susanna R Cohen
In our sample, interest in self-removal was high, and most participants who had attempted self-removal did so successfully and without problems. Providing accessible information about self-removal in preferred formats may help to reduce barriers to IUD discontinuation and support reproductive autonomy.
OBJECTIVES: We sought to assess current and former intrauterine device (IUD) users' interest in and experiences with IUD self-removal and to examine associations between participant characteristics, past experiences with removal, and future interest in self-removal.
STUDY DESIGN: We conducted a cross-sectional follow-up survey of HER Salt Lake participants who had ever used an IUD and consented to follow-up. Participants completed an electronic survey assessing interest in receiving self-removal information, past self-removal attempts and outcomes, and experiences with provider removal. We used descriptive statistics and χ2 tests to explore self-removal interest and experiences, and differences in interest by characteristics and past removal experiences.
RESULTS: More than one-half of the 621 participants (57%) expressed an interest in IUD self-removal. Among current IUD users, 49% reported willingness to try self-removal. One in 10 participants had attempted self-removal; 68% were successful and most (61%) reported no problems. Among those who attempted self-removal, the most commonly reported problems were experiencing more pain than they felt comfortable with (21%) and being unable to feel their IUD strings (9%). Participants who faced prior barriers to provider removal, including cost, scheduling delays, discomfort with care, or distrust of the health care system, were more likely to express interest in self-removal (p < .05). Those interested were also more often nulliparous, current IUD users, those not married or cohabitating with their partners, and those who did not identify as heterosexual.
CONCLUSION: In our sample, interest in self-removal was high, and most participants who had attempted self-removal did so successfully and without problems. Providing accessible information about self-removal in preferred formats may help to reduce barriers to IUD discontinuation and support reproductive autonomy.