RT Journal Article
SR Electronic
T1 Barriers and myths that limit the use of intrauterine contraception in nulliparous women: a survey of Brazilian gynaecologists
JF Postgraduate Medical Journal
JO Postgrad Med J
FD The Fellowship of Postgraduate Medicine
SP 376
OP 381
DO 10.1136/postgradmedj-2016-134247
VO 93
IS 1101
A1 da Silva-Filho, Agnaldo Lopes
A1 Lira, Josefina
A1 Rocha, Ana Luiza Lunardi
A1 Carneiro, Márcia Mendonça
YR 2017
UL http://pmj.bmj.com/content/93/1101/376.abstract
AB Objective To understand the extent to which barriers and misperceptions about intrauterine contraception (IUC) remain among Brazilian gynaecologists, particularly for nulliparous women.Methods An online survey was developed to assess Brazilian gynaecologists' knowledge and attitudes towards IUC. Data collected included demographic and professional data, main barriers when considering IUC for women in general and/or nulliparous women, attitudes towards inclusion of IUC in contraceptive counselling, and opinions on what could increase IUC prescription for nulliparous women. A question regarding knowledge about WHO medical eligibility criteria (WHO MEC) was also included in the survey.Results 101 gynaecologists completed the survey. The insertion rate in nulliparous women was 79.2%. Brazilian gynaecologists were more likely to consider IUC in counselling or provide it on request for parous than for nulliparous women (p<0.05) and perceived more complications in nulliparous women. 74.2% of gynaecologists recognised a higher risk of pelvic inflammatory disease (PID)/infertility associated with IUC use in nulliparous women than in parous women. Difficult and painful insertion were also relevant for 83.2% and 77.3% of the gynaecologists, respectively. Respondents showed a high level of awareness of the WHO MEC classification.Conclusions The three most commonly reported barriers to considering IUC as a contraceptive option for nulliparous woman were concerns about PID and difficult or painful insertion. The challenge is to ensure that gynaecologists understand the evidence and do not disregard IUC as a potential option for nulliparous women.