title: Increasing intrauterine contraception use by reducing barriers to post-abortal and interval insertion.
abstract: BACKGROUND
  We hypothesize that barriers to IUD insertion are central to low utilization in the USA. This study evaluates methods to minimize barriers, including post-abortal insertion, staff training and simplified screening.
  
  
  METHODS
  We obtained data on IUD utilization during three study periods: a control period (Period 1), a period after initiating post-abortal insertion and staff training (Period 2), and a period with these interventions plus simplified screening for interval insertions (Period 3). We evaluated IUD utilization, associated complications and utilization at a similar local agency in which the interventions were not implemented.
  
  
  RESULTS
  We inserted 2172 IUDs during the study, including 1493 interval and 679 post-abortal insertions. In the control period, there were 28 monthly IUD insertions on average, compared to 71 (a 151% increase) and 122 (a 334% increase) in Periods 2 and 3, respectively. IUD utilization at the nearby agency remained relatively constant. Complications remained low.
  
  
  CONCLUSIONS
  IUD utilization can be substantially increased through relatively simple, low-cost interventions, with significant potential to reduce unintended pregnancy.
authors.affiliation: University of California, San Francisco, San Francisco, CA 94110, USA. goodmanmd1@aol.com
authors.forename: Suzan
authors.initials: S
authors.lastname: Goodman
authors.forename: Sarah K
authors.initials: SK
authors.lastname: Hendlish
authors.forename: Courtney
authors.initials: C
authors.lastname: Benedict
authors.forename: Matthew F
authors.initials: MF
authors.lastname: Reeves
authors.forename: Madeline
authors.initials: M
authors.lastname: Pera-Floyd
authors.forename: Anne
authors.initials: A
authors.lastname: Foster-Rosales
mesh_terms: D000032:Abortion, Therapeutic; D000328:Adult; D000075202:Contraindications; D005193:Family Planning Services / Q000193:education / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D007318:Inservice Training; D007434:Intrauterine Devices / Q000706:statistics & numerical data*; D010818:Practice Patterns, Physicians'; D011247:Pregnancy