Intrauterine Device Self-Removal Practices During the COVID-19 Pandemic among Family Planning Clinics

Objectives: To explore the prevalence of intrauterine device self-removal practices before and during the COVID-19 pandemic among family planning clinics. Study Design: This is a secondary analysis of data from a descriptive, longitudinal study using a clinic-based convenience sample from the Abortion Clinical Research Network assessing baseline and pandemic-adaptive family planning practices. Results: Of the 63 sites that provided contraception, 5 (7.9%) reported providing guidance on intrauterine device self-removal at baseline. Sixteen sites (25.4%) provided guidance on self-removal by the end of the study period. Self-removal counseling was associated with being an academic center and reporting a median lower number of monthly contraceptive encounters. Conclusions: Endorsement of IUD self-removal increased to one-quarter of sites by the final timepoint. Implications: Twenty-five percent of family planning clinics reported provision of intrauterine device self-removal guidance by eight months into the COVID-19 pandemic, a three-fold increase from base-line; these findings suggest clinician support for patient autonomy in contraceptive self-management and limited concern for safety issues with self-removal during a public health emergency. (c) 2022 Elsevier Inc. All rights reserved.