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Original research article| Volume 104, ISSUE 6, P654-658, December 2021

Self-removal of long-acting reversible contraception: A content analysis of YouTube videos

      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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      References

        • Finer LB
        • Jerman J
        • Kavanaugh ML.
        Changes in use of long-acting contraceptive methods in the United States, 2007-2009.
        Fertil Steril. 2012; 98: 893-897https://doi.org/10.1016/j.fertnstert.2012.06.027
        • Kavanaugh ML
        • Jerman J.
        Contraceptive method use in the United States: trends and characteristics between 2008, 2012 and 2014.
        Contraception. 2018; 97: 14-21https://doi.org/10.1016/j.contraception.2017.10.003
        • Sobel L
        • Salganicoff A
        • Frederiksen B.
        New title X regulations: implications for women and family planning providers.
        Kais Fam Found. 2019; : 1-10
        • Jones RK
        • Witwer E
        • Jerman J
        • White K
        • Hopkins K
        • Aiken ARA
        • Stevenson A
        • Hubert C
        • Grossman D
        • et al.
        The impact of reproductive health legislation on family planning clinic services in Texas.
        Am J Public Health. 2015; 105: 851-858https://doi.org/10.2105/AJPH.2014.302515
        • Lindbergh L
        • VandeVusse A
        • Mueller J
        • Kirstein M.
        Early impacts of the COVID-19 pandemic: findings from the 2020 Guttmacher Survey of reproductive health experiences.
        Guttmacher Institute, 2020
        • Senderowicz L
        • Higgins J.
        Reproductive autonomy is nonnegotiable, even in the time of COVID-19.
        Perspect Sex Reprod Health. 2020; 52: 81-85https://doi.org/10.1363/psrh.12152
      1. ACOG. COVID-19 FAQs for Obstetrician–Gynecologists, Gynecology 2021. https://www.acog.org/en/clinical-information/physician-faqs/covid19-faqs-for-ob-gyns-gynecology (accessed April 26, 2021).

        • Kaunitz AM.
        COVID-19 gynecology practice recommendations from ACOG.
        NEJM J Watch Womens Health. 2020; (https://www.jwatch.org/na51312/2020/04/16/covid-19-gynecology-practice-recommendations-acog)
        • Amico JR
        • Stimmel S
        • Hudson S
        • Gold M.
        “$231 … to pull a string!!!” American IUD users’ reasons for IUD self-removal: an analysis of internet forums.
        Contraception. 2020; 101: 393-398https://doi.org/10.1016/j.contraception.2020.02.005
        • Foster DG
        • Grossman D
        • Turok DK
        • Peipert JF
        • Prine L
        • Schreiber CA
        • et al.
        Interest in and experience with IUD self-removal.
        Contraception. 2014; 90: 54-59https://doi.org/10.1016/j.contraception.2014.01.025
        • Roberts D.
        Killing the black body: race, reproduction, and the meaning of liberty.
        Vintage Books, New York1998
        • Heilman JM
        • West AG.
        Wikipedia and medicine: quantifying readership, editors, and the significance of natural language.
        J Med Internet Res. 2015; 17https://doi.org/10.2196/jmir.4069
        • Vogel L
        Dr. YouTube will see you now.
        Can Med Assoc J CMAJ Ott. 2011; 183: 647-648
        • Ache KA
        • Wallace LS.
        Human papillomavirus vaccination coverage on YouTube.
        Am J Prev Med. 2008; 35: 389-392https://doi.org/10.1016/j.amepre.2008.06.029
        • Agrawal S
        • Irwin C
        • RK Dhillon-Smith
        An evaluation of the quality of online information on emergency contraception.
        Eur J Contracept Reprod Health Care. 2021; 0: 1-6https://doi.org/10.1080/13625187.2021.1887476
        • Jerman J
        • Onda T
        • Jones RK.
        What are people looking for when they Google “self-abortion”?.
        Contraception. 2018; https://doi.org/10.1016/j.contraception.2018.02.006
        • Nguyen BT
        • Allen AJ.
        Social media and the intrauterine device: a YouTube content analysis.
        BMJ Sex Reprod Health. 2018; 44: 28-32https://doi.org/10.1136/bmjsrh-2017-101799
        • Paul J
        • Boraas CM
        • Duvet M
        • Chang JC.
        YouTube and the single-rod contraceptive implant: a content analysis.
        J Fam Plann Reprod Health Care. 2017; 43: 195-200https://doi.org/10.1136/jfprhc-2016-101593
        • Weiss E
        • Moore K.
        An assessment of the quality of information available on the internet about the IUD and the potential impact on contraceptive choices.
        Contraception. 2003; 68: 359-364https://doi.org/10.1016/j.contraception.2003.07.001
        • Raifman S
        • Barar R
        • Foster D.
        Effect of knowledge of self-removability of intrauterine contraceptives on uptake, continuation, and satisfaction.
        Womens Health Issues. 2018; 28: 68-74https://doi.org/10.1016/j.whi.2017.07.006
        • Kramer RD
        • Higgins JA
        • Godecker AL
        • Ehrenthal DB.
        Racial and ethnic differences in patterns of long-acting reversible contraceptive use in the United States, 2011–2015.
        Contraception. 2018; 97: 399-404https://doi.org/10.1016/j.contraception.2018.01.006
        • Gomez AM
        • Fuentes L
        • Allina A
        Women or LARC first? Reproductive autonomy and the promotion of long-acting reversible contraceptive methods.
        Perspect Sex Reprod Health. 2014; 46: 171-175https://doi.org/10.1363/46e1614
        • Jackson AV
        • Karasek D
        • Dehlendorf C
        • Greene Foster D
        Racial and ethnic differences in women's preferences for features of contraceptive methods.
        Contraception. 2016; 93: 406-411
        • Amico JR
        • Heintz C
        • Bennett AH
        • Gold M.
        Access to IUD removal: data from a mystery-caller study.
        Contraception. 2020; 101: 122-129https://doi.org/10.1016/j.contraception.2019.10.008

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