Impact of years of experience on perceived contraindications and barriers to the use of IUDs: A survey of family planning providers

In spite of their efficacy in preventing unintended pregnancies, IUDs are still relatively under-utilized by American women. While cost of these methods is clearly a barrier to use, IUDs have had a long and sometimes controversial history and earlier versions were removed from the market. This study explores the degree to which the length of licensure for providers is related to their attitudes toward or fears about these methods. Data come from a 2010 survey of 159 clinicians in Colorado and Iowa, collected as part of two statewide initiatives to reduce unintended pregnancy. Providers were asked about service barriers to prescribing these methods and for which patients they perceived them to be suitable and safe. The resultant data showed that practitioners licensed for 20 years or longer were less likely than those licensed more recently to believe that IUDs were suitable and safe for various groups, including those with a history of STIs and teenagers for Mirena use and being a smoker for use of ParaGard. More experienced clinicians were also more likely to report service barriers, such as cumbersome insurance requirements. Those with the lowest levels of experience were less likely to report service barriers, especially low patient interest or insurance. This paper explores potential reasons for these findings and suggests trainings to recognize and overcome these barriers so as to promote consistent and accurate practice across clinicians, regardless of years of experience.