Patients Pull the Strings: A Pilot Study of IUD Self-Removal Simulation

IUD self- removal

This study aims to evaluate patient perspectives and experiences related to intrauterine contraceptive device (IUD) self-removal through two surveys and to teach patients how to self-remove IUD through simulation. Patients will be recruited for this study at the time of presentation to the office for IUD removal. After consenting to the procedure, they will complete a pre-intervention survey, watch a video explaining how to self-remove the IUD, and use two models to simulate IUD removal. After completion of using the models to practice IUD removal, they will complete a second short survey. The patient will then be given the option of attempting self-removal and be given time to attempt the removal. If they elect to have the provider remove their IUD, the provider will do so. At the end of the encounter, the patient will fill out a final survey. Research staff will measure the length of the strings of all IUDs prior to routine disposal of the device.

IUD self-removal addresses two crises – that of the COVID-19 pandemic and of inequity in IUD removal. The ability to self-remove a contraceptive device prevents an unnecessary office visit, minimizing COVID exposure and maintaining appointment space for patients whose clinical circumstances require an in-person evaluation. IUD self-removal also addresses racial and socioeconomic barriers to contraceptive discontinuation by returning autonomy to the patient’s decision-making process. IUD self-removal is a feasible and cost-efficient method of contraceptive management that also gives patients more autonomy and promotes a reproductive justice-centered approach to the IUD.

The primary objective of this study is to determine whether the educational intervention and simulation of IUD self-removal change participants’ willingness, comfort, and confidence to remove their own devices. The study will also examine what proportion of participants who attempt self-removal are able to do so successfully. Secondary objectives of the study will include examining predictors of desire to attempt IUD self-removal, ability or non-ability to self-remove, and barriers to IUD removal. 

Want more information about this study? Call the BEACON Research Team at 617-383-3500 or email us at dg-infofp@bmc.org.

OB/GYN Clinic, Yawkey Ambulatory Care Center, 5th Floor, Boston Medical Center, 850 Harrison Avenue, Boston, MA 02118
⌨ dg-infofp@bmc.org | ☏ 617-383-3500