title: Barriers to Immediate Post-placental Intrauterine Devices among Attending Level Educators.
abstract: OBJECTIVE
  To determine whether barriers to immediate post-placental intrauterine device (PPIUD) placement exist at the provider level.
  
  
  METHODS
  Obstetrics providers at seven academic teaching hospitals in Massachusetts were asked to complete an electronic survey regarding their knowledge, experience, and opinions about immediate PPIUDs.
  
  
  RESULTS
  Eighty-two providers, including obstetricians, family medicine physicians, and midwives, completed the survey. Thirty-five (42.7%) reported experience placing an immediate PPIUD with the majority of them having placed three to five PPIUDs. Of participants who had never placed a PPIUD, the reason cited most frequently was inadequate training. Fewer than one-half (43.4%) correctly identified the PPIUD expulsion rate, whereas 75.9% knew the correct expulsion rate for interval IUD placement. The majority of providers responded that PPIUDs are acceptable in certain clinical scenarios.
  
  
  CONCLUSIONS
  Overall, knowledge and experience with PPIUD placement is relatively low. As increasing numbers of states amend Medicaid policy to include reimbursement for immediate postpartum IUDs, additional education and training opportunities are needed.
authors.affiliation: Department of Obstetrics and Gynecology, Boston Medical Center/Boston University School of Medicine, Boston, Massachusetts. Electronic address: Erica.holland@bmc.org.
authors.forename: Erica
authors.initials: E
authors.lastname: Holland
authors.affiliation: Department of Obstetrics and Gynecology, Boston Medical Center/Boston University School of Medicine, Boston, Massachusetts.
authors.forename: L Daniela
authors.initials: LD
authors.lastname: Michelis
authors.affiliation: Department of Obstetrics and Gynecology, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania.
authors.forename: Sarita
authors.initials: S
authors.lastname: Sonalkar
authors.affiliation: Department of Obstetrics and Gynecology, University of Miami School of Medicine, Miami, Florida.
authors.forename: Christine L
authors.initials: CL
authors.lastname: Curry
mesh_terms: D001291:Attitude of Health Personnel; D005260:Female; D019538:Health Care Surveys; D007722:Health Knowledge, Attitudes, Practice; D006784:Hospitals, Teaching; D006801:Humans; D007434:Intrauterine Devices; D008297:Male; D008404:Massachusetts; D009721:Nurse Midwives / Q000706:statistics & numerical data; D010820:Physicians / Q000706:statistics & numerical data; D049590:Postpartum Period; D011247:Pregnancy; D012449:Safety; D011795:Surveys and Questionnaires; D013997:Time Factors