6th Int'l Symposium on IUDs - Day 2

EVENT 1
6th International Symposium on IUDs

September 30, 2020

Patients First and Demography

(Day 2 of 7 Day Series)

EVENT 1: September 30, 2020 (Day 2)
Patients First and Demography

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What does it mean to center patients for IUD care and research?
(Presenter: Jamila Perritt)

“Systems must be designed to act at the intersection of inequity. This requires movement beyond a single-issue analysis to a system that considers contexts, examines policies and procedures that reproduce and perpetuate past and current injustices, and grounds our understanding in lived experience of individuals so that we can build strategic coalitions and movements. This allows providers and researchers to align their values with the users of IUDs to ensure that user autonomy is protected.”

Patient-centered contraceptive care
and IUD access
(Presenter: Liza Fuentes)

“It is essential that users are centered in the decision to use or discontinue contraception. Reasons why users might consider IUD self-removal as an option include regret, bias, coercion, method dissatisfaction, self-autonomy, and costs. The ability to remove an IUD or have one removed when discontinuation is desired is an essential part of building trust in a patient-provider relationship.”

Tools for patient-centered IUD care
(Presenter: Christine Dehlendorf)

“When considering contraception provision in general, and LARC provision specifically, it is essential to focus on patient-centered care, defined as care that is respectful and responsive to individual needs, values, and preferences. To accomplish this, providers must not make assumptions about how patients value or prioritize contraceptive effectiveness. Counseling tools that present effectiveness as one, but not necessarily the most important, characteristic influencing method choice can facilitate patient-centered care. Performance measures focused on patient experience of care, including whether individuals felt respected and received appropriate decision support, can also help ensure that providers and systems do not provide directive or coercive care.
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Global overview on IUD prevalence,
access, trends over time
(Presenter: Moazzam Ali)

“The global proportion of IUD use is 13%. However, the prevalence in low income and lower middle income countries is 4 to 5%, accounting for 29% and 46% of the modern method mix in low income and lower middle income countries respectively. Access to information about contraceptive methods is low in most sub-Saharan African countries, although availability is surprisingly high in many African countries. According to a WHO survey, IUDs are provided theoretically free of charge in Low- and Middle-Income countries. Key challenges include removing restrictions that prohibit IUD service provision by nurses, midwives, and other paramedical staff, and removing restrictions that prohibit services to nulliparous and adolescent contraceptive users. The issue of bias against IUD provision exists among providers because of the complexity of IUD delivery compared to injectables/implants. However, recent trends towards improved pre-natal care and institutional deliveries offer opportunities for postpartum IUD insertions.”

IUD use in the United States:
trends and characteristics
(Presenter: Megan Kavanaugh)

“The marked increase in IUD use in the United States that has been documented over the past two decades has been parallel to shifts in method use among the most and moderately effective method groups. Among IUD users in the United States, hormonal options are more popular than the copper IUD, with 73% of IUD users using a hormonal IUD as of 2014. As of 2016, characteristics associated with higher IUD use in the United States include having sought family planning care in the past year, being a college graduate and having given birth. Income levels and race are no longer associated with IUD use."

IUD usage and devices in China
(Presenter: Yan Che)

“IUD use accounts for more than 50% of contraceptive use in China. Because of high failure with Stainless Steel Rings (dating back to 1958) China has shifted using copper/medicated hybrid IUD technologies. China has numerous copper IUDs that release indomethacin; the indomethacin reduces menstrual blood loss and other side effects. Since 2001 when China relaxed the strict one-child policy, many IUD users have switched to shorter-acting contraceptive methods.”

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