Strategies for improving the acceptability and acceptance of the copper intrauterine device

Perinatal contraceptive counselling and community-based interventions may be effective for improving uptake of copper IUD contraception.

Comment: The quality of evidence is downgraded by several study limitations.

Summary

A Cochrane review included 9 studies with a total of 7960 women (7 randomised controlled trials and 2 controlled before and after studies). Contraceptive counselling and referrals by community workers showed an increase in uptake of the IUD among intervention groups (Peto OR 2.00; 95% CI 1.40 to 2.85; 3 trials, n=6224; I²=86%). 2 studies on antenatal contraceptive counselling also favoured the intervention groups (Peto OR 2.33; 95% CI 1.39 to 3.91; 2 trials, n=1491; I²=72%). One study on postnatal couple contraceptive counselling showed an increase in IUD uptake compared to control (Peto OR 5.73, 95% CI 3.59 to 9.15; n=600), while another one evaluating postnatal home visits showed a tendency but did not reach statistical significance (OR 1.60, 95% CI 0.90 to 2.85; n=849). Two studies on enhanced postabortion contraceptive counselling did not reach statistical significance.

Clinical comments

Date of latest search: 2 September 2011

Ədəbiyyat

1. Arrowsmith ME, Aicken CR, Saxena S et al. Strategies for improving the acceptability and acceptance of the copper intrauterine device. Cochrane Database Syst Rev 2012;3:CD008896.