From Anxiety to Comfort: IUD Insertion, Pain Management, and Patient-Centered Counseling
Lisa Bayer, MD, MPH,discusses how unplanned pregnancy rates remain high in the US, particularly among disadvantaged communities. She also explores how intrauterine devices (IUDs) offer effective contraception despite underutilization. She emphasizes that physicians should address patient concerns directly, develop individualized pain management plans with patient input, acknowledge the gap between physician perception and patient experience of insertion pain, and implement environmental modifications and strong rapport to improve the overall experience while ensuring proper follow-up care.
EP. 1: Understanding the Rates of Unplanned Pregnancy in the United States
March 11th 2025Panelists discuss how nearly 46% of pregnancies in the US are unplanned. Although this rate has declined, the US still has one of the highest rates of unplanned pregnancies in the world, particularly affecting minority and disadvantaged communities.
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EP. 2: Overview of IUD Mechanisms and Barriers to Use
March 18th 2025Panelists discuss how intrauterine device (IUD) usage rates are increasing but remain low despite the availability of hormonal and new copper options. Obstacles include physician education gaps, patient anxieties about procedures, high up-front costs (especially for the uninsured), and misconceptions about fertility risks that modern IUDs do not pose.
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EP. 3: Reducing Anxieties of IUD Placement
March 25th 2025Panelists discuss how physicians should empower and educate patients about intrauterine devices (IUDs) by addressing concerns directly rather than downplaying them, acknowledging pain as a legitimate issue while presenting all available options, and recognizing that IUDs are not appropriate for everyone. No patient should feel pressured to choose this method.
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EP. 4: Empowering Patients and Addressing Concerns in IUD Placement
April 1st 2025Panelists discuss how developing an effective pain management plan for intrauterine device (IUD) insertion requires patient cooperation, thorough medical history review, comprehensive education about procedures and tools, consideration of individualized needs, planning for interventions like sedation or antianxiety medication (which may not always be available), and implementation of trauma-informed care principles to ensure true informed consent and patient autonomy.
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EP. 5: Addressing the Patient/Provider Disconnect in Reported Pain
April 8th 2025Panelists discuss how physicians consistently underestimate intrauterine device (IUD) placement pain compared to patients’ reported experiences. They emphasize that addressing this disparity requires physician humility, community education initiatives, and adherence to standardized guidelines such as the CDC’s updated 2024 pain management recommendations.
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EP. 6: Managing Patient Experiences During and After IUD Placement
April 15th 2025Panelists discuss how environmental modifications based on patient preferences are crucial during intrauterine device (IUD) placement, including verbal comfort, adjusted lighting, distractions, and heating pads. They emphasize that physician rapport significantly impacts pain perception, acknowledging that postprocedure discomfort can last for days. They also ensure that patients receive comprehensive management guidelines and contact information for follow-up support.
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