Discussing intrauterine contraception at the family planning visit: A (missed) opportunity for client education

The modern IUC is a highly effective, safe, long-acting, reversible method of contraception with few side effects and high user satisfaction. While the IUC is the most widely used contraceptive method worldwide, less than 2% of sexually active women in the US use this method. California's Family PACT program recently implemented efforts to expand IUC use. Using data from a representative survey (N=1497) of Family PACT clients interviewed immediately after their family planning visit, we explored provider and client characteristics associated with discussing IUCs at the visit. Among a sample of 1265 non-pregnant female clients, 27% reported that the provider discussed the IUC method with them that day. Clients 20 and older were more likely than teens to report discussing IUCs with their providers (29% vs. 19%, p<0.01). Clients seen at private sector providers were more likely than those seen at public sector providers to discuss IUCs (35% vs. 22%, p<0.001), and clients seen at primary care or multi-specialty providers were more likely than those seen at family planning-only providers to discuss IUCs (33% vs. 22%, p<0.001). Very few clients (4%) were using IUCs before the interview visit, and just 2% switched from lower efficacy methods of contraception to an IUC at the visit. 42% of clients listed “not knowing enough about the method” as a reason for not using an IUC, pointing to the need for improved client education. Further research should evaluate the reasons for disparities between age, provider sectors, and specialties in discussing IUC with clients.