Biomedical Sciences ETDs

Author

Shannon Carr

Publication Date

12-1-2015

Abstract

Background: Post-placental intrauterine device (IUD) insertion has the potential to reduce rapid repeat pregnancies. As the procedure becomes more widely adopted in the US, it is important to understand womens perceptions about the procedure. Studies examining patient-centered outcomes are currently lacking. Objectives: The objectives of this study include: 1) To describe women's experiences with post-placental IUD insertion through postpartum semistructured interviews. 2) To establish a mean pain score for the procedure using a 100mm visual analogue scale (VAS). 3) To assess procedural pain using a 4-point Likert verbal rating scale (VRS). Methods: This concurrent mixed methods pilot study was conducted at the University of New Mexico Hospital. Women with and without an epidural were enrolled. Procedural pain was assessed using the VAS and VRS immediately after IUD placement and at the time of the interviews. Interviews were conducted prior to hospital discharge. The interviews explored participants' decision pathways, procedure experience, decisional regret, and contraception knowledge. Interview data were coded and analyzed iteratively to identify emergent themes. Participants rated their overall satisfaction on a 5-point Likert scale at the end of the interview. Results: In the no epidural group 30 women underwent pain assessment and nine participated in an interview. In the epidural group 36 women underwent pain assessment and 12 participated in an interview. The VAS scores did not demonstrate a normal distribution in both the no epidural and epidural groups. The median VAS scores were 40.5mm and 2.8mm in the no epidural and epidural groups, respectively. In the no epidural group, 53.3% of women reported none-mild pain. Most women (88.9%) in the epidural group reported none-mild pain. The interview data did not reveal substantial differences between the no epidural and epidural groups. Women's satisfaction with the procedure was high in both groups. Convenience was the dominant decision-driver to undergo the procedure. Actual procedural pain and duration were less than expected among the majority of interviewees. Conclusions: Women who undergo post-placental IUD insertion report high satisfaction and no regrets about the procedure. Our study offers valuable counseling points to offer women if they are considering post-placental IUD placement.

Keywords

intrauterine device, postpartum, pain, patient-centered outcomes

Sponsors

Fellowship of Family Planning

Document Type

Thesis

Language

English

Degree Name

Biomedical Sciences

Level of Degree

Masters

Department Name

Biomedical Sciences Graduate Program

First Advisor

Singh, Rameet

First Committee Member (Chair)

Sussman, Andrew

Second Committee Member

Espey, Eve

Third Committee Member

Rogers, Rebecca

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