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
N1 - Funding Information:
Funding Source: The FECOND surveys were supported by a grant from the French Ministry of Health, a grant from the French National Agency of Research (#ANR-08-BLAN-0286-01; PIs N. Bajos, C Moreau), a grant from the National Institute of Prevention and health Education (INPES) and funding from National Institute of Health and Medical Research (INSERM) and the National Institute for Demographic Research (INED).
Funding Information:
Funding: The FECOND study was supported by a grant from the French Ministry of Health, a grant from the French National Agency of Research (#ANR-08-BLAN-0286-01; PIs N. Bajos, C Moreau), and funding from the National Institute for Demographic Research (INED).
Copyright:
Copyright 2021 Elsevier B.V., All rights reserved.
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
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U2 - 10.1016/j.contraception.2013.10.003
DO - 10.1016/j.contraception.2013.10.003
M3 - Article
C2 - 24239330
AN - SCOPUS:84889098272
SN - 0010-7824
VL - 89
SP - 9
EP - 16
JO - Contraception
JF - Contraception
IS - 1
ER -