Search

The article discusses a study on the use of copper intrauterine device (IUD) for emergency contraception. It presents findings that show the low level of recommendation by clinicians for the copper IUD and IUD insertions despite its high efficacy and contraceptive benefits. The study advised that patient-centered and high-quality care for emergency contraception should include a discussion of the most effective method.

The authors comment on the importance of family planning to address global health, environmental and economic problems. They argue that family planning is essential to improve the rights, health and freedom of women and their families. According to them, one of the most efficient ways of decreasing abortion rates is the use of contraceptive methods.

A letter to the editor in response to the article "Addressing Global Health, Economic and Environmental Problems Through Family Planning," by J. Joseph Speidel and Richard A. Grossman published in a 2011 issue and a reply by the authors to this are presented.

Objective: Intrauterine contraception is used by many women worldwide, however, it is rarely used in the United States. Although available at no cost from the state family planning program for low-income women in California, only 1.3% of female patients obtain intrauterine contraceptives annually. This study assessed knowledge and practice patterns of practitioners regarding intrauterine contraception., Methods: We conducted a survey among physicians, nurse practitioners, and physician assistants (n=1,246) serving more than 100 contraceptive patients per year in the California State family planning program. The response rate was 65% (N=816). We used multiple logistic regression to measure the association of knowledge with clinical practice among different provider types., Results: Forty percent of providers did not offer intrauterine contraception to contraceptive patients, and 36% infrequently provided counseling, although 92% thought their patients were receptive to learning about the method. Regression analyses showed younger physicians and those trained in residency were more likely to offer insertions. Fewer than half of clinicians considered nulliparous women (46%) and postabortion women (39%) to be appropriate candidates. Evidence-based views of the types of patients who could be safely provided with intrauterine contraception were associated with more counseling and method provision, as well as with knowledge of bleeding patterns for the levonorgestrel-releasing intrauterine system and copper devices., Conclusion: Prescribing practices reflected the erroneous belief that intrauterine contraceptives are appropriate only for a restricted set of women. The scientific literature shows intrauterine contraceptives can be used safely by many women, including postabortion patients. Results revealed a need for training on updated insertion guidelines and method-specific side effects, including differences between hormonal and nonhormonal devices., Level of Evidence: III.