Intrauterine contraception in Saint Louis: a survey of obstetrician and gynecologists' knowledge and attitudes

Background: Many obstacles to intrauterine contraception (IUC) use exist, including provider and patient misinformation, high upfront cost and clinician practice patterns. The aim of our study was to investigate knowledge and attitudes about IUC among obstetricians and gynecologists in the area of Saint Louis. Study Design: We mailed a self-administered, anonymous survey to 250 clinicians who provide obstetric and gynecologic care in Saint Louis City and County which included questions about demographics, training, family planning visits and intrauterine contraceptive knowledge and use. Results: The overall survey response rate among eligible clinicians was 73.7%. Clinicians who had recently finished training or saw higher numbers of contraceptive patients per week were more likely to insert IUC than clinicians who completed training prior to 1989 or saw fewer contraceptive patients. Several misconceptions among clinicians were identified, including an association between intrauterine contraceptives and an elevated risk of pelvic inflammatory disease. Conclusions: Physician misconceptions about the risks of IUC continue to occur. Improved clinician education is greatly needed to facilitate the use of these highly effective, long-acting, reversible methods of contraception.