“$231 … to pull a string!!!” American IUD users’ reasons for IUD self-removal: An analysis of internet forums

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Jennifer R. Amico, Samantha Stimmel, Shawna Hudson, Marji Gold

Contraception

February 5, 2020

This study describes the reasons for IUD self-removal as documented in internet forums by IUD users discussing self-removal.

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.

Contraception

An International Reproductive Health Journal

Wishes to advance reproductive health through the rapid publication of the best and most interesting new scholarship regarding contraception and related fields such as abortion.

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REFERENCES

Provider Bias in Long-Acting Reversible Contraception (LARC) Promotion and Removal: Perceptions of Young Adults
Sep 2016
Am J Publ Health
Jenny Higgins, Renee D. Kramer, Kristin M Ryder

Frequent Surfing on Social Health Networks is Associated With Increased Knowledge and Patient Health Activation
Aug 2016
J MED INTERNET RES
Dafna Grosberg, Haya Fogel-Grinvald, Haim Reuveni, Racheli Magnezi

U.S. Medical Eligibility Criteria for Contraceptive Use, 2016
Jul 2016
Kathryn M Curtis, Naomi K. Tepper, Tara C Jatlaoui, Maura K Whiteman

How a moderated online discussion forum facilitates support for young people with eating disorders
Jan 2016
Sarah Elizabeth Kendal, Susan Kirk, Rebecca Elvey, Steven Pryjmachuk

Are Health Behavior Change Interventions That Use Online Social Networks Effective? A Systematic Review
Feb 2014
J MED INTERNET RES
Carol Maher, Lucy Lewis, Katia Ferrar, Corneel Vandelanotte

Explicit and implicit information needs of people with depression: A qualitative investigation of problems reported on an online depression support forum
May 2011
BMC PSYCHIATRY
Lisa J Barney, Kathleen Margaret Griffiths, Michelle A Banfield

The Doctor, the Patient and the World-Wide Web: How the Internet is Changing Healthcare
Mar 2003
J ROY SOC MED
J A Powell, Marcia Claire Darvell, J A M Gray

Access to IUD removal: Data from a mystery-caller study
Dec 2019
CONTRACEPTION
Jennifer R. Amico, Chiara Heintz, Ariana H. Bennett, Marji Gold

Taking the provider “out of the loop:” Patients' and physicians' perspectives about IUD self-removal
Jun 2018
CONTRACEPTION
Jennifer Amico, Ariana Bennett, Alison Karasz, Marji Gold

“I wish they could hold on a little longer” : Physicians' Experiences With Requests for Early IUD Removal
May 2017
CONTRACEPTION
Jennifer Amico, Ariana Bennett, Alison Karasz, Marji Gold

“She just told me to leave it”: Women's Experiences Discussing Early Elective IUD Removal
Apr 2016
Jennifer Amico, Ariana Bennett, Alison Karasz, Marji Gold

Accuracy of Information about the Intrauterine Device on the Internet
Nov 2015
Am J Obstet Gynecol
Tessa Madden, Sarah Cortez, Marie D Kuzemchak, Mary C Politi

Changes in Use of Long-Acting Reversible Contraceptive Methods Among U.S. Women, 2009-2012
Oct 2015
OBSTET GYNECOL
Megan Kavanaugh, Jenna Jerman, Lawrence B Finer

The Sage Handbook of Qualitative Research
Dec 1994
BRIT J EDUC STUD
Gill Crozier, N.K. Denzin, Y.S. Lincoln

Effects of Age, Parity, and Device Type on Complications and Discontinuation of Intrauterine Devices
Feb 2014
OBSTET GYNECOL
Joelle Aoun, Virginia A Dines, Dale W Stovall, Veronica Gomez-Lobo

Interest in and experience with IUD self-removal
Jul 2014
Diana Greene Foster, Daniel Grossman, David K. Turok, Eleanor Bimla Schwarz

Characteristics Associated With Discontinuation of Long-Acting Reversible Contraception Within the First 6 Months of Use
Nov 2013
OBSTET GYNECOL
Danielle S Grunloh, Teya Casner, Gina Secura, Tessa Madden

Twenty-Four–Month Continuation of Reversible Contraception
Oct 2013
OBSTET GYNECOL
Micaela Oʼneil-Callahan, Jeffrey F Peipert, Qiuhong Zhao, Gina Secura

Disparities in Abortion Rates: A Public Health Approach
Aug 2013
Am J Publ Health
Christine Dehlendorf, Lisa H Harris, Tracy Weitz

"i think it depends on the body, with mine it didn't work": Explaining young women's contraceptive implant removal
Jun 2013
Lesley Hoggart, Victoria Louise Newton, Jane Dickson

Knowledge and Attitudes about Long-Acting Reversible Contraception Among Latina Women Who Desire Sterilization
Jul 2013
WOMEN HEALTH ISS
Kari White, Kristine Hopkins, Joseph E Potter, Daniel Grossman

Continuation of Reversible Contraception in Teenagers and Young Women
Dec 2012
OBSTET GYNECOL
Jessica R Rosenstock, Jeffrey F Peipert, Tessa Madden, Gina Secura

Contraceptive Features Preferred by Women At High Risk of Unintended Pregnancy
Sep 2012
Lauren N. Lessard, Deborah Karasek, Sandi Ma, Diana Greene Foster

Content Analysis: An Introduction To Its Methodology
Mar 1984
J AM STAT ASSOC
Klaus Krippendorff

Continuation and Satisfaction of Reversible Contraception
May 2011
OBSTET GYNECOL
Jeffrey F Peipert, Qiuhong Zhao, Jenifer E Allsworth, Gina Secura

Contraceptive Failure in the United States
May 2011
James Trussell

Health care providers’ knowledge about contraceptive evidence: A barrier to quality family planning care?
Apr 2010
Christine Dehlendorf, Kira Levy, Rachel Ruskin, Jody Steinauer

Contraceptive failure in the United States
Sep 2004
CONTRACEPTION
James Trussell

What is it about intrauterine devices that women find unacceptable? Factors that make women non-users: A qualitative study
May 2006
J FAM PLAN REPROD H
Claire Asker, Helen Stokes-Lampard, Jackie Beavan, Sue Wilson

Qualitative research evaluation methods: Integrating theory and practice.
Patton M.Q.