Abstract
Objective
The copper intrauterine contraceptive (IUC) is the most effective method of emergency
contraception (EC), yet it is underutilized. The objective was to evaluate a pilot
project integrating the copper IUC into EC care.
Study Design
Single-group evaluation study. Nine geographically diverse reproductive health centers
implemented 6-month pilot interventions. All interventions included staff education
and inclusion of the IUC in EC patient counseling; some sites developed patient education
materials. Health center staff completed manual monthly tracking forms of the number
of EC patients receiving oral levonorgestrel, ulipristal acetate or the copper IUC.
Sites also tracked and reported the number of patients returning for removal during
the 6-month pilot period and for 5 subsequent months. Main study outcomes included
the number of IUC for EC insertions, the proportion that were same-day insertions
and the proportion of patients receiving each EC type during the pilot period. A secondary
outcome was the number of patients who had returned for removal at 5 months postpilot.
Results
There were 101 IUC insertions for EC during the pilot period. Seventy-seven percent
were same-day insertions; the remainder returned for insertion within 5 days of unprotected
intercourse. The percentage of EC patients choosing the IUC varied by site from 1
to 16% (overall=7%). At 5 months postpilot, 20 patients (20%) had returned for removal.
Conclusions
Some women will be interested in the copper IUC for EC, and therefore, all women should
be offered this option. Results suggest that the large majority continued to use the
IUC for ongoing contraception.
Implications
Copper IUCs are a viable option for women in need of EC. All women should be offered
the most effective EC option.
Keywords
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Article info
Publication history
Published online: February 11, 2016
Accepted:
February 8,
2016
Received in revised form:
February 6,
2016
Received:
June 10,
2015
Footnotes
☆Potential conflicts of interest: PPFA has collaborated on research studies with HRA Pharma, the manufacturers of emergency contraceptive products available in the US, and participated in a previous investigator-initiated research study sponsored by Teva Women's Health, the manufacturer of the copper intrauterine contraceptive device currently available in the US
Identification
Copyright
© 2016 Elsevier Inc. All rights reserved.
