The 130th Annual Meeting of APHA

Abstract #50188

Eve Espey, MD¹, Joseph Anthony Ogburn, MD², David King Espey, MD³, and Virgil Etsitty, MD¹. (1) Department of OB-GYN - 4ACC, University of New Mexico, 2211 Lomas Ave. NE, Albuquerque, NM 87131, (505) 272-6309, eespey@salud.unm.edu, (2) Department of OB/Gyn, University of New Mexico, 2211 Lomas Blvd. Ne, Albuquerque, NM 87131-5286, (3) Indian Health Service National Epidemiology Program, 5100 Homestead NE, Albuquerque, NM 87110

Intrauterine devices (IUDs) are chosen by 1% of women contraceptors in the United States. Usage among Navajo women is similarly low. Before the publicity and litigation surrounding the Dalkon Shield in the 1980s, 5% of all women and 30% of Navajo women chose the IUD as their contraceptive method. Despite a large body of research supporting the safety and efficacy of IUDs, low usage rates of the IUD persist. The objective of this study was to identify knowledge, attitudes and training on the part of providers that create barriers to IUD use. A survey of Navajo Area IHS providers who counsel patients regarding contraceptive methods was performed. A total of 109 providers returned the survey for a response rate of 75%. Overall, knowledge and attitudes were favorable toward the IUD. Only 8% recommended the IUD to no one, and 66% reported they were currently inserting IUDs. Only 17%, however, had inserted more than 10 in the previous year. A significant minority felt (36%) reported inadequate training to insert IUDs, and the majority of these providers were family practice physicians. Provider responses indicated that misperceptions about the IUD persist despite evidence to the contrary. Finally, the expense of the IUD or liability concerns do not appear to be barriers to usage. This study demonstrated that provider attitudes and training in the Navajo Area Indian Health Service may only partially explain low usage. Educational interventions should focus on training in insertion techniques and should be targeted to family practice physicians.

Learning Objectives:

• Describe current attitudes about the advantages and disadvantages of the intrauterine devices among Navajo Area Indian Health service providers
• Describe providers' experience in utilizing intrauterine device
• Understand barriers to improved intrauterine device usage among Navajo women
• Understand barriers to improved usage of intrauterine devices in Navajo women 2)

Keywords: Navajo, Family Planning

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.