Title : “Just a pinch”? A national survey of provider attitudes regarding IUD procedure analgesia management and options
Abstract:
Introduction: The intrauterine device (IUD) is a popular and effective contraception option, however, pain associated with insertion remains a chief concern for recipients as well as a barrier for obtaining an IUD. Pain localized to the gynecologic community has an extensive history of being ignored and minimized– pain associated with IUD procedures is no exception. The purpose of this study is to better understand differences in professional training and opinions regarding analgesia for IUD procedures.
Methods: We conducted a national Web-based Qualtrics survey of IUD providers (n=657). The 63-question survey asked about providers’ professional demographics, likelihood of providing various forms of analgesia to nulliparous and multiparous patients, cervical preparation, and procedural instrumentation.
Results: Linear-regression models and one-way ANOVA tests were used to determine significant differences in the frequency of analgesia recommendation by provider demographics. Prescribing practices were found to vary by professional credentials (CNM vs. MD/DO), location (urban, rural, suburban), region, and race. Notably, cisgender male providers and providers in practice more than five years were significantly less likely to prescribe multiple analgesic methods to both nulliparous and multiparous patients.
Conclusions/ Implications: The variability in prescribing practices observed in this study is concerning. It suggests that some patients undergoing IUD insertion are not offered all analgesic methods that may be available. This research highlights the need to continue conversations regarding provision of analgesia for IUD insertion and adopt a more patient-centered approach to minimize suffering.
Audience Take Away:
- Findings about differences in analgesia for IUD procedures in regards to type of analgesia and provider demographics.
- Call to attention about gaps of analgesia care of gynecologic patients.
- Call to attention of the need of personalized approach for IUD analgesia.
