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Developing an evidence-based IUD self-removal guide: a pilot study

Lyndsey Benson, University of Washington

Project abstract

Intrauterine Devices (IUDs) are highly effective provider controlled methods. The reproductive autonomy of IUD users is threatened when they are unable to access IUD removal due to cost, access, or provider bias. One quarter of women surveyed after an abortion procedure said that they would consider trying an IUD if they could remove it themselves. A recent study of IUD self-removal found that only 1 in 5 women were successful in removing their IUDs in a clinical setting. Increasing IUD self-removal success gives IUD users control over their contraceptive method and may improve user satisfaction with their IUD. Empowering IUD users to self-remove is also a harm-reduction approach to combat potential provider and payer bias that may disproportionately affect poor women. We propose a two phase pilot study to develop an IUD self-removal guide based on IUD user and provider feedback, and to test the feasibility of using this IUD self-removal guide in a clinical setting. We will develop an IUD-self removal guide through interviews with IUD users who have attempted self-removal, qualitative analysis of YouTube videos with advice on self-removal, and focus groups with family planning providers. The removal guide will be piloted in a clinical setting where IUD-users seeking removal will be randomized 1:1 to receive the IUD self-removal guide or attempt self-removal without the guide. Results of this pilot study will help refine this novel intervention and inform recruitment, sample size, and procedures for a larger clinical trial.

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