PITTSBURGH, April 3, 2014 – Health care clinics should routinely offer same-day placement of intrauterine devices (IUDs) to women seeking emergency contraception, according to researchers at the University of Pittsburgh School of Medicine. The study findings, published online in the journal Contraception, demonstrate that providing patient education along with same-day placement service increases both knowledge and use of IUDs three months and a year after women seek emergency contraception.
"Women seeking emergency contraception, who are at very high risk of undesired pregnancy, deserve clear information about the most effective contraceptives available," explained Eleanor Bimla Schwarz, M.D., M.S., director of the women's health services research unit at the Center for Research on Health Care, Pitt School of Medicine, and lead author of the study.
Dr. Schwarz and colleagues compared knowledge and use of IUDs and contraceptive implants among women seeking emergency contraception at an inner-city clinic eight months before and 21 months after it began providing structured counseling and offering same-day IUD or implant placement. A total of 186 women between the ages of 15 and 45 who wanted to avoid pregnancy for at least six months completed surveys immediately and three and 12 months after their clinic visit. Data from the clinic's electronic medical record provided additional information about contraceptive initiation during the course of the study.
Researchers found that after the clinic began offering structured counseling, more women had accurate knowledge of the effectiveness of IUDs and started to use either an IUD or implant. Thus, this change in clinic policy dropped the number of women using no form of contraception from 17 percent to 3 percent. Data obtained from the electronic medical records indicated that when the option of same-day placement was offered, 11 percent of women received a same-day IUD, and according to survey data, of those who received this service, 88 percent and 80 percent reported continued use at a three- and 12-month follow-up, respectively.
"The results of our study demonstrate that we can make 'same-day service with a smile' our standard of care," concluded Dr. Schwarz. "By fully educating our patients about their contraceptive options and providing convenient access to desired services, we empowered women to effectively avoid undesired pregnancies."
Additional co-authors of this study include Melissa Papic and Erin Baldauf, both of the University of Pittsburgh School of Medicine; Sara M. Parisi, of the University of Pittsburgh Graduate School of Public Health, Department of Epidemiology; and Rachel Rapkin and Glenn Updike, of the University of Pittsburgh, Department of Obstetrics, Gynecology and Reproductive Sciences.
The study was funded by the Department of Health and Human Services Office of Population Affairs.
About the University of Pittsburgh School of Medicine
As one of the nation's leading academic centers for biomedical research, the University of Pittsburgh School of Medicine integrates advanced technology with basic science across a broad range of disciplines in a continuous quest to harness the power of new knowledge and improve the human condition. Driven mainly by the School of Medicine and its affiliates, Pitt has ranked among the top 10 recipients of funding from the National Institutes of Health since 1998. In rankings recently released by the National Science Foundation, Pitt ranked fifth among all American universities in total federal science and engineering research and development support. Likewise, the School of Medicine is equally committed to advancing the quality and strength of its medical and graduate education programs, for which it is recognized as an innovative leader, and to training highly skilled, compassionate clinicians and creative scientists well-equipped to engage in world-class research. The School of Medicine is the academic partner of UPMC, which has collaborated with the University to raise the standard of medical excellence in Pittsburgh and to position health care as a driving force behind the region's economy. For more information about the School of Medicine, see http://www.medschool.pitt.edu.
Journal
Contraception