The Intrauterine Device: Still Misunderstood After All These Years

, Division of Maternal Health, Center for Maternal and Child Health, Maryland Department of Health and Mental Hygiene, Baltimore.

South Med J. 2000;93(9) 

In This Article

Abstract and Introduction

The intrauterine device (IUD) is one of the most effective, safe, and economic methods of contraception today. It is used by more women worldwide than any other reversible method of birth control, yet less than 1% of women in the United States use the IUD. Still remembering the tragedy of the notorious Dalkon Shield, American pharmaceutical companies and clinicians have been wary about promoting any IUD, leaving most physicians inadequately trained in the two IUDs available in the United States. Most significantly, misconceptions about the IUD's safety, mechanism of action, complication rates, and liability have severely limited the utilization of the IUD by many practitioners and women in the United States who may greatly benefit from it.

In 1959, the first major article published in the United States about the IUD appeared in the American Journal of Obstetrics and Gynecology.[1] This article sparked renewed interest in the IUD and marked the birth of the modern IUS in the United States. In the following decade, because of the development of a malleable polyethylene plastic, a deluge of new devices of assorted sizes and shapes ensued. However, soon after the introduction of one of these devices, the Dalkon Shield, enthusiasm for all IUDs ceased abruptly.


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