Trying to choose a method of birth control can make a woman feel as if she's drowning in a sea of hormones, latex and copper. But a new study might offer some clarity. It turns out that when it comes to birth control, women's health providers themselves prefer to use intrauterine devices, or IUDs.
The research, conducted in 2013 by Planned Parenthood and the Hospital of Cook County, Illinois, found that nearly 42 percent of female women's health providers said they prefer long-acting reversible contraceptives (LARCs) for their own personal method of birth control. About 40 percent specifically chose IUDs, the T-shaped devices that are inserted into the uterus to prevent pregnancy for up to 12 years. By comparison, the 2011–2013 National Survey of Family Growth found that only about 12 percent of women from the general population opted to use LARCs during that time.
The findings about women's health providers, which appeared last week on the website of the journal Contraception, drew on surveys of 488 doctors, nurse practitioners, physician assistants and other health care workers. These women were significantly more likely to use IUDs or the vaginal ring than any other method -- and significantly less likely than the general female population to use female sterilization or condoms as a form of birth control.
The research did not investigate causes for the discrepancy, but Lisa Stern, the lead author of the study, suspects what previous research has already suggested: Women may not be getting accurate information about IUDs.
"There are myths out there about IUDs spreading infection, or about IUDs making people infertile, that probably still affect many women's perceptions of the devices," Stern, a registered nurse who holds a master's degree in nursing, told The Huffington Post.
Back in the 1980s, IUD use fell in response to the Dalkon Shield scandal of the 1970s, when a manufacturer misrepresented the safety of a faulty device that ultimately caused infertility, injury and/or related infections to about 200,000 women, of whom 20 died. But IUDs have since become much safer and must clear a high bar for FDA approval. Currently, the American Congress of Obstetricians and Gynecologists and the American Academy of Pediatrics both consider IUDs the most effective form of reversible contraception and have deemed them safe for most reproductive-age women.
Stern said that providers have the most accurate knowledge of which methods are most effective, and tend to make personal decisions based on that. According to the Centers for Disease Control and Prevention, condoms fail to protect against pregnancy 18 percent of the time and oral contraceptives fail 9 percent of the time. That's compared to a failure rate for IUDs of less than 1 percent. But IUDs may not be within everyone's price range.
"Upfront cost is probably not an issue, or maybe is less of an issue, to family planning providers who have steady income or are likely to have health insurance that covers contraception like IUDs," said Stern.
Of course, just because your doctor chose an IUD for herself, it doesn't mean it's the right decision for you. Choosing a form of birth control means finding a balance between personal preference, affordability and convenience -- it's not a one-size-fits-all situation. In addition, IUDs involve a medical procedure to insert, and a subsequent procedure to remove or replace -- conditions that may not appeal to everyone. The devices are generally effective, but they can cause irregular bleeding and they don't protect against sexually transmitted diseases.
Ultimately, if you're a woman weighing her options about birth control, this study doesn't provide a definitive answer -- it's just one more thing you might want to take into account. Whether or not your provider discloses her preferred method, it can be helpful to know what providers in general choose for themselves as you consider the possibilities.
"People are doing the right thing to weigh the cost and benefit of whichever method they choose," said Stern.
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