Most Women Think The Morning-After Pill Is The Most Effective Form Of Emergency Contraception. It's Not.
Exclusive: Only 13% of women surveyed by an Australian reproductive health organisation knew copper IUDs were an option.
The copper intrauterine device is the most effective form of emergency contraception but it is under-utilised by Australian women, as they're not always offered it as an option by their doctors, new research has found.
The research, led by a team from Family Planning New South Wales, surveyed 470 clients and found only 13% of them were even aware that a copper IUD could be used for emergency contraception.
Although 64.5% of them had used emergency contraception before, just 2% had chosen the device over an emergency contraceptive pill, the study published in the European Journal of Contraception & Reproductive Health Care found.
The copper IUD is the most effective form of emergency contraception, with a failure rate of less than 0.1%. To work, it must be inserted within five days of unprotected sex or contraceptive failure. Once in place, it provides immediate, effective and ongoing contraception for up to a decade and is instantly reversible when removed, with no impact on fertility.
Family Planning NSW senior research officer Dr Jessica Botfield said one barrier to accessing the device was cost.
“The copper IUD isn’t on the [Pharmaceutical Benefits Scheme] although it is very cost effective because you keep it in and use it as contraception for 5 to 10 years,” she said.Approximately, the emergency pill “can cost between $20 and $50 [and] they’re about 85% effective, versus [the copper IUD], which is $100 and more than 99% effective,” she added.
The copper IUD is a small plastic device with a fine copper wire wrapped around the stem. A fine nylon thread is attached to the end of the IUD and it comes out through the cervix into the top end of the vagina. There are two types available in Australia, one lasts for five years and the other for 10 years.
Australian women aren't alone — the device is the least frequently used form of emergency contraception globally, but the study found when given information on the effectiveness, side-effects and cost, 46.8% of clients surveyed in the study said they would consider it as an option.
The study also surveyed 55 clinicians.
"One of the other findings was that clinicians weren't necessarily offering the copper IUD as an option but they were offering the emergency contraception pill," Botfield said.
Most (94%) of clinicians had discussed oral emergency contraception options with their clients, while just over half had discussed the copper IUD. The clinicians reported "time pressures" as the main barrier to offering the IUD as an option.
One of the side effects includes a potential increase in heavy menstrual bleeding. A study published in 2018 found in the first nine weeks after insertion, two-thirds of participants reported increased menstrual blood loss, but this percentage dropped gradually over subsequent weeks.
"It might not be for everyone, but the more options people have, the better," Botfield said. "I think having the copper IUD on the PBS and also allowing nurses and midwives to [claim a Medical Benefits Scheme rebate] when inserting the device would improve access."
The research received no external funding.