A Qualitative Study of Young Women's Beliefs About Intrauterine Devices: Fear of Infertility

• Published in: Journal of midwifery & women's health Vol. 61; no. 4; pp. 482 - 488
• Main Authors: Payne, Jackelyn B., Sundstrom, Beth, DeMaria, Andrea L.
• Format: Journal Article
• Language: English
• Published: United States Blackwell Publishing Ltd 01.07.2016; Wiley Subscription Services, Inc
• Subjects: Activities of daily living; Adolescent; At risk; Birth control; Contraception; Contraception - adverse effects; Contraception - instrumentation; Contraception - methods; Contraception - psychology; Contraceptives; Decision making; Elderly women; Fear; Fear & phobias; Female; fertility; Grounded theory; Health care; Health Knowledge, Attitudes, Practice; Humans; Identity; Infertility; Infertility, Female - etiology; Infertility, Female - psychology; Interviews as Topic; Intrauterine devices; Intrauterine Devices - adverse effects; IUD; Medical research; Nursing; Obstetricians; Patient Acceptance of Health Care - psychology; Pregnancy; Qualitative Research; Reversible; Risk assessment; Southeastern United States; Unwanted pregnancy; Uptake; women's health; Women's issues; Womens health; Young Adult; Young women; United States > US; young adult; intrauterine devices; contraception; fertility; women's health
• ISSN: 1526-9523; 1542-2011
• DOI: 10.1111/jmwh.12425

Introduction Approximately 80% of college‐aged women are at risk of unintended pregnancy. The American College of Obstetricians and Gynecologists recommends long‐acting reversible contraceptive (LARC) methods, including intrauterine devices (IUDs), as first‐line pregnancy prevention for adolescents and young women. Yet, less than 5% of 15‐ to 19‐year‐old women using a method of contraception use LARC. Limited research explores young women's concerns about IUDs. Methods As part of a larger women's health research study, researchers conducted 53 in‐depth interviews with women, aged 18 to 24 years enrolled in a midsized liberal arts college in the southeastern United States. Analytical techniques from the grounded theory approach were used to code line‐by‐line and identify themes emerging from these data. Results Fear of causing harm or infertility through IUD use emerged as a significant barrier to uptake. Negative and often unfounded beliefs about IUDs led to silence and limited observability of IUDs in daily life and health care contexts. Identity as a fertile woman emerged as an antecedent factor to the compatibility of IUDs with participants’ values and beliefs. Discussion The link between fear of infertility and perceived identity was found to be a major factor in young women's contraceptive decision making. In order to increase uptake of IUDs, the beliefs of women must be addressed.