ABSTRACT
Objective: IUD is a highly effective, safe, private, long-acting, and rapidly reversible method of contraception with few side effects. The aim of this study was to assess the continuation rate and cause of IUD discontinuation in Isfahan, Iran
Materials and methods: This historical Cohort study was carried out on 12 randomly selected health centers of Isfahan province in 2007. 244 literate married reproductive aged women [15-49 years old] who had chosen IUD as a contraceptive method in 2002 enrolled the study by census sampling. After explaining the aim of study and taking informed consent, women completed the questionnaire for demographic characteristics, menstrual characteristics before and after IUD insertion and cause of IUD discontinuation. Data were analyzed by SPSS 11 software, descriptive statistics and Kaplan-Meier analysis
Results: Continuation rates at the end of 1, 2, 3, 4, 5 and 6 years were 100, 92, 87, 76, 66 and 65 per 100, respectively. Since 2001-2007, 60% [146] preserved and 40% [98] removed their IUD. 27.6% [27] discontinued IUD use due to occurring medical problems that the most common cause was infection [29.6%]. 72.4% [71] had voluntary IUD removal and the most common cause was tendency to planned pregnancy [38%]
Conclusion: These findings indicate that health care providers should give more emphasis to counseling programs for women desiring IUD insertion
ABSTRACT
Despite Intra Uterine Device [IUD] has the advantage of providing long-term contraception and does not require daily attention, only%8 of Iranian women use it. This study was conducted to enhance understanding of why women in the Isfahan appear reluctant to consider IUD as a contraceptive method. It was a qualitative study that was done in Isfahan in May 2009. Five urban health centers of Isfahan city were selected randomly. In each center by purposive opportunistically sampling, interview was done with referring women of reproductive age that had never used IUD without any contraindication by one interviewer. One to one semi-structured interviews were continued until a level of information saturation was reached and no new themes were emerging. Each woman's believe about IUD and her reasons for not using IUD as a contraceptive method was asked by interviewer. Also all participants were asked about the official [leaflets, health care professionals, books and school] and unofficial [personal narratives recounted by friends and relatives] sources of their information. Eleven interviews were conducted in total. Key words in ideas of each woman were identified to develop major misconceptions about IUD use. Fear of side effects of IUD, religious believes, anxieties related to fitting of an IUD, make difficulty in intercourse and damage to fetus were the major misconceptions about IUD use. Religious believes were the most impediment factor for IUD use. All of the items identified mirrored those found in other studies except the prominent worries about religious aspects of using IUD that are new and need wider exploration