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Grand Rounds: Encouraging more patients to choose an IUD (Cover Story)

Recent FDA label changes that put to rest safety concerns about IUDs make them an excellent first-line contraceptive option for most of your patients-even those not in a monogamous relationship.

Key Points

A 16-year-old patient named Elena has just delivered her second baby. For the last 4 months she has been "dating" the baby's father, who uses condoms. She has used pills in the past but "forgets to take them a lot." Elena requests an IUD and wants a "sure" method so that she can finish high school. What would you do?

The most common form of reversible contraception throughout the world, IUDs are safe and highly effective.1 So why is their use in the United States so dismally low-with fewer than 2% of women choosing an IUD as their contraceptive method?2 Low rates result partly from misperceptions about the IUD by clinicians and patients alike, as well as persistent negative impressions lingering from the Dalkon Shield controversy of the 1970s.