Predictors of Non-use of Intrauterine Contraception among women aged 18-49 years in a General practice setting in the UK

Objectives: Our research examined the barriers to the uptake of Intrauterine Contraception (IUC) by women in a general practice setting in the UK. This paper reports predictors of non-use of IUC in this context. Design: We used a mixed method QUAL/Quant approach in which initial qualitative research provides a framework for subsequent larger quantitative surveys. Utilising findings derived from 30 qualitative interviews, a quantitative survey was developed and distributed to a pragmatic sample of 1195 women, aged 18-49 years, who were recruited through 32 participating GP practices in an area of England, UK. Outcome measures were percentage of attributes or responses in the sample and use or non-use of IUC. Results were analysed using descriptive statistical analysis and binary logistic regression, using Use/Non-Use as a binary response variable. Results: Attitudinal variables which were the strongest predictors of non-use of IUC were; an adverse opinion on long acting aspect of IUC (OR=8.34), disliking the thought of IUC inside the body (OR=3.138), concerns about IUC causing difficulties becoming pregnant in the future (OR=2.587), concerns about womb damage (OR=2.224), having heard adverse opinions about levonorgestrel - releasing IUS (Mirena®) (OR= 2.551), having an adverse opinion of having light, irregular periods (OR=2.382) and having an adverse opinion of having no periods (OR=2.018). Conclusions: Concerns about the long-acting nature of IUC and persisting concerns about the safety of IUC may act as barriers to its use. Information for women, tailored to specifically address these concerns, is needed.