Abstract
Objective
To explore publicly available information about the self-removal of long-acting reversible
contraception (LARC) on a popular video-sharing website.
Study design
We conducted a comprehensive keyword search of YouTube videos related to self-removal
of LARC—namely intrauterine devices and implants. We analyzed video content to explore
demographic characteristics, method and duration of LARC use, and motivations and
experiences of self-removal.
Results
Our keyword search identified 58 videos that met the criteria for inclusion, including
48 videos that featured individuals who removed an intrauterine device and 10 who
removed an implant. Collectively, videos had over 4 million views. We identified most
video creators as white (53%), 31% as Black, and 14% as Latinx. Users were motivated
to remove their own device by both preferences and barriers to formal care. Most individuals
in our sample (n = 56/58) successfully removed their device and described their experience in positive
terms related to the ease of removal. Reasons for LARC discontinuation included negative
side effects, fear of potential side effects, and desire for pregnancy.
Conclusion
This study builds upon prior research by describing publicly available information
about LARC self-removal. The over representation of Black women in our sample may
reflect a higher prevalence of LARC self-removal among this population. Positive experiences
of self-removal and high levels of viewer engagement with online videos suggest a
need for provider counseling on LARC removal at the time of insertion.
Implications
Prior to LARC insertion, patients should be made aware of any financial requirements
for discontinuation. Provider counseling for self-removal at the time of insertion
will likely minimize health risks and affirm patient reproductive autonomy.
Keywords
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Article info
Publication history
Published online: August 13, 2021
Accepted:
August 2,
2021
Received in revised form:
July 30,
2021
Received:
May 4,
2021
Identification
Copyright
© 2021 Elsevier Inc. All rights reserved.
