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


It has been more than 25 years since the last Dalkon Shield was inserted, yet its legacy of pelvic infections and lawsuits has still managed to tarnish the reputation of all other IUDs, leaving only two IUD options in the United States. Although many carefully planned medical studies with large databases have since asserted the safety of all current IUDs for women at low risk for sexually transmitted diseases, the IUD is not used by 99% of women in the United States. Unfortunately, because so few women are using IUDs, a significant number of ob/gyn and family practice physicians are finishing residency training without ever having done a single IUD insertion. Misconceptions about the IUD's risk for infection, ectopic pregnancy, liability, and mechanism of action persist despite scientific evidence to the contrary. Research studies report no increased incidence of PID or ectopic pregnancy in copper IUD users. Recent information also defines the IUD's principal mode of action as prevention of fertilization.

The IUD is a cost-effective, long-term, convenient, reversible contraceptive with high efficacy, minor side effects, and rare complications. It is time to educate women and providers about the effectiveness and safety of IUDs and to provide this underused method to more women in the United States.


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