Patient knowledge about and intention to use the intrauterine contraceptive device (IUCD) at a tertiary-level hospital

Background. The intrauterine contraceptive device (IUCD) is a highly effective and safe method of contraception. Prevention of unwanted pregnancies has made its use a matter of national priority in certain countries. Despite numerous advantages and suitability, the uptake of the IUCD is poor. Patients in South Africa (SA) seem to lack knowledge regarding this contraceptive. Objectives. To determine the quantity and quality of knowledge about the IUCD, and to evaluate its acceptability for future use. Methods. A prospective cross-sectional study was conducted at Pelonomi Tertiary Hospital. A total of 201 consecutive patients were interviewed using structured questionnaires: of these, 193 formed the final study group. Results. Almost half (49.2%, n=95) of our patients were aware of the existence of the IUCD. Its use was very low, with only one patient having used it before. Overall qualitative knowledge was poor, even among those aware of the existence of the IUCD. There was a significant association between level of education and knowledge, with patients having passed grade 12 or higher significantly more likely to have knowledge of the IUCD than those at lower levels (relative risk 1.57, 95% confidence interval 1.18 - 2.08). Forty-five percent (n=86) of patients indicated a desire for future IUCD use. Conclusion. Despite the availability of the IUCD in SA clinics and hospitals, its uptake is poor. Awareness of this method seems to have improved over the past few years, but the qualitative knowledge is still considerably lacking. Education plays a major role in the knowledge of contraception. Better educational aids at all facilities will increase its use and reduce unwanted pregnancies.