“ Although ACOG does not recommend that women remove IUDs themselves, some IUD users who wish discontinuation may, after counseling, choose to attempt self-removal. This ACOG guidance, which is continually updated as new findings emerge, should help clinicians caring for women to provide judicious, timely advice during the COVID-19 pandemic.
This study describes the reasons for IUD self-removal as documented in internet forums by IUD users discussing self-removal.
In our current climate focused on improving access to IUDs, it is essential to address and reduce barriers to IUD removal when desired, in order to preserve reproductive autonomy.
Reasons for discontinuation of IUD:
Bleeding Pattern (27.5%), Pain (25%), Weight Gain (5%); Other Reasons (42.5%)
Baseline generalized pelvic pain may not be a risk factor for IUD discontinuation within one year of placement.
IUD self-removal is an option that some patients may be interested in. Addressing concerns about safety may make self-removal more appealing to some patients. Addressing physicians' concern about "hasty" removal may require additional training so that providers are better able to support patients' decision-making around contraceptive use. Implications: The option of self-removal could have a positive impact on reproductive autonomy and patient-decision making.
We encourage contraceptive counseling and removal protocols that directly address historical reproductive injustices and that honor patients' wishes.
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