Goodman Suzan, Hendlish Sarah K, Benedict Courtney, Reeves Matthew F, Pera-Floyd Madeline, Foster-Rosales Anne
University of California, San Francisco, San Francisco, CA 94110, USA.
Contraception. 2008 Aug;78(2):136-42. doi: 10.1016/j.contraception.2008.03.008. Epub 2008 Jun 18.
We hypothesize that barriers to IUD insertion are central to low utilization in the USA. This study evaluates methods to minimize barriers, including post-abortal insertion, staff training and simplified screening.
We obtained data on IUD utilization during three study periods: a control period (Period 1), a period after initiating post-abortal insertion and staff training (Period 2), and a period with these interventions plus simplified screening for interval insertions (Period 3). We evaluated IUD utilization, associated complications and utilization at a similar local agency in which the interventions were not implemented.
We inserted 2172 IUDs during the study, including 1493 interval and 679 post-abortal insertions. In the control period, there were 28 monthly IUD insertions on average, compared to 71 (a 151% increase) and 122 (a 334% increase) in Periods 2 and 3, respectively. IUD utilization at the nearby agency remained relatively constant. Complications remained low.
IUD utilization can be substantially increased through relatively simple, low-cost interventions, with significant potential to reduce unintended pregnancy.
我们假设宫内节育器（IUD）插入的障碍是美国IUD使用率低的核心问题。本研究评估了将障碍最小化的方法，包括流产后插入、工作人员培训和简化筛查。
我们获取了三个研究阶段的IUD使用数据：一个对照期（第1阶段）、开始流产后插入和工作人员培训后的阶段（第2阶段），以及有这些干预措施并加上简化的间隔期插入筛查的阶段（第3阶段）。我们评估了IUD的使用情况、相关并发症以及在未实施这些干预措施的类似当地机构的使用情况。
在研究期间我们共插入了2172个IUD，包括1493个间隔期插入和679个流产后插入。在对照期，平均每月有28次IUD插入，相比之下，第2阶段和第3阶段分别为71次（增加了151%）和122次（增加了334%）。附近机构的IUD使用率保持相对稳定。并发症发生率仍然很低。
通过相对简单、低成本的干预措施可大幅提高IUD使用率，具有显著降低意外怀孕的潜力。
