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“I think maybe 10 years seems a bit long.” Beliefs and attitudes of women who had never used intrauterine contraception
  1. Susan Walker1,
  2. Victoria Louise Newton2,
  3. Lesley Hoggart2,
  4. Michael Parker3
  1. 1 Faculty of Health, Social Care and Education, Anglia Ruskin University, Chelmsford, UK
  2. 2 School of Health, Well-being and Social Care, The Open University, Milton Keynes, UK
  3. 3 Anglia Ruskin University, Postgraduate Medical Institute, Chelmsford, UK
  1. Correspondence to Dr Susan Walker, Faculty of Health, Social Care and Education, Anglia Ruskin University, Chelmsford CM1 1SQ, UK; susan.walker{at}


Aim To explore, in a general practice setting, the concerns, beliefs and attitudes about intrauterine contraception (IUC) reported by women, who had never used the methods.

Methods We used a sequential mixed-method (QUAL/quant) approach. A pragmatic, self-selecting sample of 30 women, aged 18–46 years, who had never used IUC), was recruited through seven general practices in South East England. Themes arising from qualitative interviews were used to construct a quantitative survey, completed by a pragmatic sample of 1195 women, aged 18–49 years, attending 32 general practices in the same region, between February and August 2015.

Results Qualitative themes were concerns about the long-acting nature of IUC, concerns about body boundaries, and informal knowledge of IUC, especially ‘friend of a friend’ stories. Women were not sure if the devices can be removed before their full 5- or 10-year duration of use, and felt that these timeframes did not fit with their reproductive intentions. Quantitative survey data showed that the most commonly endorsed concerns among never-users were painful fitting (55.8%), unpleasant removal of the device (60.1%), and concern about having a device ’inside me' (60.2%).

Conclusions To facilitate fully informed contraceptive choice, information provided to women considering IUC should be tailored to more fully address the concerns expressed by never-users, particularly around the details of insertion and removal, and concerns about the adverse, long-term effects of the device. Women need to be reassured that IUC can be removed and fertility restored at any time following insertion.

Trial registration Trial registration NIHR CRN portfolio; 15912.

  • Intrauterine Devices
  • Intrauterine Systems
  • Long-acting Reversible Contraception
  • Qualitative Research
  • General Practice
  • England
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  • Contributors Elektra Lapavits provided research assistance. Catherine Bannister helped to review the literature.

  • Funding This research was funded by Bayer PLC, who manufacture a number of intrauterine contraceptive devices. Bayer PLC played no part in the design, analysis or interpretation of this study, apart from requesting that attitudes towards the Jaydess intrauterine system be explored in the interviews.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Ethics approval Ethical approval for this project was obtained from NRES Committee London South East (14/LO/0004). This study was registered on the NIHR CRN Portfolio, study ID 15912 "Acceptability of intrauterine contraception: a mixed methods study" prior to starting the study.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement Due to the personal and sensitive nature of the qualitative data in this paper we have not asked permission for data sharing.

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