title: Interest in and experience with IUD self-removal.
abstract: OBJECTIVE
  In the United States, the popularity of intrauterine devices (IUDs) is low despite many positive attributes such as high effectiveness and ease of use. The requirement that a clinician remove the IUD may limit US women's interest in the method. Our objective was to describe women's experience with self-removal and its effect on attitudes toward the method.
  
  
  METHODS
  We assessed interest in attempting and success in IUD self-removal among women seeking IUD discontinuation from five US health centers. Women were given the option of attempting self-removal of the IUD. Participants were asked to complete two surveys about their reasons for desiring IUD removal, attitudes toward IUD use and experience with self-removal and/or clinician removal.
  
  
  RESULTS
  Three hundred twenty-six racially diverse women participated (mean age, 28 years; body mass index, 27; duration of IUD use, 3 years); more than half were willing to try self-removal [95% confidence interval (CI): 45-65%], and among those who tried, one in five was successful (95% CI: 14-25%). More than half of participants (54%) reported they were more likely to recommend IUD use to a friend now that they know that it might be possible to remove one's own IUD; 6% reported they were less likely to recommend the IUD to a friend. African American women were particularly interested in the option of IUD self-removal.
  
  
  CONCLUSIONS
  Many women are interested in the concept of IUD self-removal, although relatively few women currently succeed in removing their own IUD.
  
  
  CONCLUSIONS
  Health educators, providers and advocates who inform women of this option potentially increase IUD use, reducing rates of undesired pregnancy.
authors.affiliation: University of California, San Francisco, CA, USA. Electronic address: fosterd@obgyn.ucsf.edu.
authors.forename: Diana Greene
authors.initials: DG
authors.lastname: Foster
authors.affiliation: Ibis Reproductive Health, Cambridge, MA, USA.
authors.forename: Daniel
authors.initials: D
authors.lastname: Grossman
authors.affiliation: University of Utah, Salt Lake City, UT, USA.
authors.forename: David K
authors.initials: DK
authors.lastname: Turok
authors.affiliation: Washington University in St. Louis, St. Louis, MO, USA.
authors.forename: Jeffrey F
authors.initials: JF
authors.lastname: Peipert
authors.affiliation: Institute for Family Health, New York, NY, USA.
authors.forename: Linda
authors.initials: L
authors.lastname: Prine
authors.affiliation: University of Pennsylvania, Philadelphia, PA, USA.
authors.forename: Courtney A
authors.initials: CA
authors.lastname: Schreiber
authors.affiliation: University of California, San Francisco, CA, USA.
authors.forename: Andrea V
authors.initials: AV
authors.lastname: Jackson
authors.affiliation: University of California, San Francisco, CA, USA.
authors.forename: Rana E
authors.initials: RE
authors.lastname: Barar
authors.affiliation: University of Pittsburgh, Pittsburgh, PA, USA.
authors.forename: Eleanor Bimla
authors.initials: EB
authors.lastname: Schwarz
mesh_terms: D000293:Adolescent; D000328:Adult; D003267:Contraception / Q000379:methods*; D003625:Data Collection; D005260:Female; D006801:Humans; D007434:Intrauterine Devices; D016015:Logistic Models; D008875:Middle Aged; D012648:Self Care / Q000379:methods*; D011795:Surveys and Questionnaires; D014481:United States; D055815:Young Adult
keywords: Contraceptive attitudes; IUD; Intrauterine contraception; Self-removal