The decline in popularity of the intrauterine device. A survey of general practitioner attitudes and practices in New South Wales.

Abstract

OBJECTIVE: To assess the attitudes and practices of general practitioners (GPs) in New South Wales in regard to intrauterine device (IUD) use. DESIGN: Randomised group comparison of 100 rural and 100 urban GPs by questionnaire. SUBJECTS: Sixty-five rural and 66 urban general practitioners took part in the study. RESULTS: Almost 50% of GPs who responded to the questionnaire always discussed the IUD when counselling about contraception, whereas 6% never discussed IUDs. Rural GPs were more likely to discuss IUD use than urban GPs. In the past, 68.7% of GPs had inserted IUDs but only 20.6% still inserted them. Fifty per cent of GPs who did not currently insert IUDs felt they lacked expertise due to less demand for IUDs from women or inadequate training. CONCLUSION: Prevailing community attitudes towards intrauterine devices have resulted in fewer requests to general practitioners for IUDs, resulting in a lack of expertise in IUD insertion. Increased litigation associated with IUD use, and subsequent publicity, has increased the cost of medical indemnity insurance. All these factors have contributed to fewer GPs being prepared to insert IUDs. Australian women are being deprived of balanced information about the benefits and risks of IUD use and of the possibility of using this very effective, low-cost, low-maintenance method of contraception.