Intrauterine contraceptive devices (IUCDs) are highly effective and recommended as first-line contraceptives for women. Very few Canadian women use these forms of contraception, and even fewer youths use these methods. Multiple research search engines allowed a literature review of papers about IUCDs, healthcare systems, patient and provider barriers, published between 2000 and 2020. Using a preference for Canadian studies identified and allowed investigating the barriers preventing the more widespread use of IUCDs by Canadian women with an emphasis placed on at-risk groups, in order to make recommendations for decreasing unintended pregnancies.
Barriers broadly fit into the three categories of the healthcare system, the patients', and practitioner-based. Evidence suggests that there is an overall lack of awareness and limited knowledge regarding IUCDs among the public, provider misconceptions and lack of confidence in insertion capabilities, high upfront cost, and the systemic issues of limited access to contraceptive providers. Studies have shown that evidence-based education and removal of cost and access related barriers increase patient acceptance of and adherence to IUCDs.
To increase the use of IUCDs by Canadian women, large scale subsidy and policies to create programmes targeted at improving public and provider education and awareness are required. Additionally, increased hands-on training and task sharing with allied providers is necessary to increase patient access and timely availability of these highly effective contraceptives.
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