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

IUD Use in the Maryland Family Planning Program

The Maryland Family Planning Program provides services to more than 70,000 women yearly. This is done through a network of more than 90 public health clinics operated by local health departments, Planned Parenthood, University of Maryland, Johns Hopkins University, and community health centers. In fiscal year 1998, approximately 55% of the women using these sites had incomes below the federal poverty level, and 96% had incomes less than 250% of the federal poverty level.[15] Seventy-five percent of women had no health insurance; however, the sliding fee scale ensures that inability to pay is not an obstacle to obtaining the contraceptive of choice.[15]

For the 25-year period from 1973 through 1998, the Table lists, in 5-year intervals, the percentage of women using the IUD as their method of birth control. For this 25-year period, IUD use in Maryland Family Planning Program fell 97%, from 19.9% of all clients in 1973 to 0.5% in 1998. During this same period, in the United States, IUD use declined 88%, decreasing from 8% in 1973 to 1% in 1998 (Fig 2).[16]

Figure 2.

Percent IUD use, 1973 to 1988, in Maryland Family Planning Program and United States. (Adapted from (1) Office of Maternal Health and Family Planning, Tabulations from Reproductive and Perinatal Information/Data System; 1973, 1978, 1983, 1988, 1993, and 1998; Maryland Department of Health and Mental Hygiene; and (2) Ortho-McNeil Pharmaceutical Corp. Tabulations from 1973, 1978, 1983, 1988, 1993, and 1998 Ortho Birth Control Study, Ortho-McNeil Pharmaceutical Corp.)

In the United States, IUD users tend to be married and older. In 1998, IUD users in the Maryland Family Planning Program ranged in age from 17 to 56, with 48% of users under age 30 and 52% age 30 and above.[15] In addition, most IUD users were single (57%).[15]


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