IUD use in France: Women's and physician's perspectives

Caroline Moreau, Aline Bohet, Danielle Hassoun, Virginie Ringa, Nathalie Bajos

Research output: Contribution to journalArticle

Abstract

Objective While the intra-uterine device (IUD) is the second most popular contraceptive method in France, its use remains low among women most at risk of unintended pregnancies. Acknowledging the conjoint role of women and physicians in contraceptive decision making, we investigate the determinants of IUD use and IUD recommendations from the user and prescriber perspectives. Study design Data are drawn from 2 national probability surveys (population-based and physician surveys) on sexual and reproductive health in France. The population based survey comprised 3,563 women ages 15-49 at risk of an unintended pregnancy in 2010 and the physician survey included 364 general practitioners (GPs) and 401 gynecologists practicing in private offices in 2010-2011. Analyses were performed using logistic regression models. Results Altogether, 21.4% of women were IUD users, with substantial differences by age and parity. Less than 1% of young women (<25 years) and 3% of nulliparous were current IUD users in 2010. The odds of IUD use were four times higher in women followed by a gynecologist as compared to a GP. Mirroring these results, gynecologists were more likely to recommend IUDs than GPs. Misconception about IUD risks was widespread among women and providers. Medical training and information, professional practice settings, and ever use of IUDs also informed physician's likelihood of recommending IUDs, regardless of specialty. Conclusions The study reveals the intersection of individual and professional influences on contraceptive use patterns. The considerable age discrepancy in IUD use in France, with very few young women most at risk of an unintended pregnancy using the method, reflects a knowledge gap shared by users and providers. These findings suggest there are significant opportunities to improve contraceptive care in France. Implications This study stresses the need to inform women and doctors about the benefits and risks of IUDs for all women. Substantial efforts are required to improve the medical curriculum, in order to promote evidenced based family planning counseling and provide GPs with the technical skills to insert IUDs.

Original languageEnglish (US)
Pages (from-to)9-16
Number of pages8
JournalContraception
Volume89
Issue number1
DOIs
StatePublished - Jan 2014

Fingerprint

Women Physicians
France
Equipment and Supplies
General Practitioners
Contraceptive Agents
Reproductive Health
Physicians
Pregnancy
Logistic Models
Professional Practice
Family Planning Services
Parity
Contraception
Curriculum
Population
Counseling
Decision Making

Keywords

  • Contraceptive behaviors
  • Evidenced based medical practices
  • France
  • Healthcare professional survey
  • Intra uterine device
  • Long acting reversible contraception

ASJC Scopus subject areas

  • Reproductive Medicine
  • Obstetrics and Gynecology

Cite this

IUD use in France : Women's and physician's perspectives. / Moreau, Caroline; Bohet, Aline; Hassoun, Danielle; Ringa, Virginie; Bajos, Nathalie.

In: Contraception, Vol. 89, No. 1, 01.2014, p. 9-16.

Research output: Contribution to journalArticle

Moreau, Caroline ; Bohet, Aline ; Hassoun, Danielle ; Ringa, Virginie ; Bajos, Nathalie. / IUD use in France : Women's and physician's perspectives. In: Contraception. 2014 ; Vol. 89, No. 1. pp. 9-16.
@article{546b5569002f4561997751d67478a9f0,
title = "IUD use in France: Women's and physician's perspectives",
abstract = "Objective While the intra-uterine device (IUD) is the second most popular contraceptive method in France, its use remains low among women most at risk of unintended pregnancies. Acknowledging the conjoint role of women and physicians in contraceptive decision making, we investigate the determinants of IUD use and IUD recommendations from the user and prescriber perspectives. Study design Data are drawn from 2 national probability surveys (population-based and physician surveys) on sexual and reproductive health in France. The population based survey comprised 3,563 women ages 15-49 at risk of an unintended pregnancy in 2010 and the physician survey included 364 general practitioners (GPs) and 401 gynecologists practicing in private offices in 2010-2011. Analyses were performed using logistic regression models. Results Altogether, 21.4{\%} of women were IUD users, with substantial differences by age and parity. Less than 1{\%} of young women (<25 years) and 3{\%} of nulliparous were current IUD users in 2010. The odds of IUD use were four times higher in women followed by a gynecologist as compared to a GP. Mirroring these results, gynecologists were more likely to recommend IUDs than GPs. Misconception about IUD risks was widespread among women and providers. Medical training and information, professional practice settings, and ever use of IUDs also informed physician's likelihood of recommending IUDs, regardless of specialty. Conclusions The study reveals the intersection of individual and professional influences on contraceptive use patterns. The considerable age discrepancy in IUD use in France, with very few young women most at risk of an unintended pregnancy using the method, reflects a knowledge gap shared by users and providers. These findings suggest there are significant opportunities to improve contraceptive care in France. Implications This study stresses the need to inform women and doctors about the benefits and risks of IUDs for all women. Substantial efforts are required to improve the medical curriculum, in order to promote evidenced based family planning counseling and provide GPs with the technical skills to insert IUDs.",
keywords = "Contraceptive behaviors, Evidenced based medical practices, France, Healthcare professional survey, Intra uterine device, Long acting reversible contraception",
author = "Caroline Moreau and Aline Bohet and Danielle Hassoun and Virginie Ringa and Nathalie Bajos",
year = "2014",
month = "1",
doi = "10.1016/j.contraception.2013.10.003",
language = "English (US)",
volume = "89",
pages = "9--16",
journal = "Contraception",
issn = "0010-7824",
publisher = "Elsevier USA",
number = "1",

}

TY - JOUR

T1 - IUD use in France

T2 - Women's and physician's perspectives

AU - Moreau, Caroline

AU - Bohet, Aline

AU - Hassoun, Danielle

AU - Ringa, Virginie

AU - Bajos, Nathalie

PY - 2014/1

Y1 - 2014/1

N2 - Objective While the intra-uterine device (IUD) is the second most popular contraceptive method in France, its use remains low among women most at risk of unintended pregnancies. Acknowledging the conjoint role of women and physicians in contraceptive decision making, we investigate the determinants of IUD use and IUD recommendations from the user and prescriber perspectives. Study design Data are drawn from 2 national probability surveys (population-based and physician surveys) on sexual and reproductive health in France. The population based survey comprised 3,563 women ages 15-49 at risk of an unintended pregnancy in 2010 and the physician survey included 364 general practitioners (GPs) and 401 gynecologists practicing in private offices in 2010-2011. Analyses were performed using logistic regression models. Results Altogether, 21.4% of women were IUD users, with substantial differences by age and parity. Less than 1% of young women (<25 years) and 3% of nulliparous were current IUD users in 2010. The odds of IUD use were four times higher in women followed by a gynecologist as compared to a GP. Mirroring these results, gynecologists were more likely to recommend IUDs than GPs. Misconception about IUD risks was widespread among women and providers. Medical training and information, professional practice settings, and ever use of IUDs also informed physician's likelihood of recommending IUDs, regardless of specialty. Conclusions The study reveals the intersection of individual and professional influences on contraceptive use patterns. The considerable age discrepancy in IUD use in France, with very few young women most at risk of an unintended pregnancy using the method, reflects a knowledge gap shared by users and providers. These findings suggest there are significant opportunities to improve contraceptive care in France. Implications This study stresses the need to inform women and doctors about the benefits and risks of IUDs for all women. Substantial efforts are required to improve the medical curriculum, in order to promote evidenced based family planning counseling and provide GPs with the technical skills to insert IUDs.

AB - Objective While the intra-uterine device (IUD) is the second most popular contraceptive method in France, its use remains low among women most at risk of unintended pregnancies. Acknowledging the conjoint role of women and physicians in contraceptive decision making, we investigate the determinants of IUD use and IUD recommendations from the user and prescriber perspectives. Study design Data are drawn from 2 national probability surveys (population-based and physician surveys) on sexual and reproductive health in France. The population based survey comprised 3,563 women ages 15-49 at risk of an unintended pregnancy in 2010 and the physician survey included 364 general practitioners (GPs) and 401 gynecologists practicing in private offices in 2010-2011. Analyses were performed using logistic regression models. Results Altogether, 21.4% of women were IUD users, with substantial differences by age and parity. Less than 1% of young women (<25 years) and 3% of nulliparous were current IUD users in 2010. The odds of IUD use were four times higher in women followed by a gynecologist as compared to a GP. Mirroring these results, gynecologists were more likely to recommend IUDs than GPs. Misconception about IUD risks was widespread among women and providers. Medical training and information, professional practice settings, and ever use of IUDs also informed physician's likelihood of recommending IUDs, regardless of specialty. Conclusions The study reveals the intersection of individual and professional influences on contraceptive use patterns. The considerable age discrepancy in IUD use in France, with very few young women most at risk of an unintended pregnancy using the method, reflects a knowledge gap shared by users and providers. These findings suggest there are significant opportunities to improve contraceptive care in France. Implications This study stresses the need to inform women and doctors about the benefits and risks of IUDs for all women. Substantial efforts are required to improve the medical curriculum, in order to promote evidenced based family planning counseling and provide GPs with the technical skills to insert IUDs.

KW - Contraceptive behaviors

KW - Evidenced based medical practices

KW - France

KW - Healthcare professional survey

KW - Intra uterine device

KW - Long acting reversible contraception

UR - http://www.scopus.com/inward/record.url?scp=84889098272&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84889098272&partnerID=8YFLogxK

U2 - 10.1016/j.contraception.2013.10.003

DO - 10.1016/j.contraception.2013.10.003

M3 - Article

C2 - 24239330

AN - SCOPUS:84889098272

VL - 89

SP - 9

EP - 16

JO - Contraception

JF - Contraception

SN - 0010-7824

IS - 1

ER -