Barriers and facilitators for providing pain control during intrauterine device insertion: a multi-center physician survey

To evaluate physicians’ barriers and facilitators, as well as knowledge, practices, attitudes, and beliefs, regarding analgesia for IUD insertion A multi-center online survey was conducted from January to July 2023 in Ontario, Canada. Data was analysed using descriptive statistics, chi-square tests, ANOVA, and thematic analysis. Among 85 providers who responded to the survey, there was a lack of consensus regarding provision of analgesia for IUD insertion, as only 52.9% routinely provided pain control. The remaining 40 providers (47.1%) stated that they do not routinely provide pain control for IUD insertion, although 87.5% of participants stated that they would provide pain control if the patient specifically requested analgesia. No differences were found between academic and community staff (p = 0.94) or less experienced providers in provision of pain control (p = 0.24). Reasons for provision of pain control included patient comfort, care, and procedure safety. Conversely, other physicians believed the pain was minimal or short-lived, or faced logistical barriers in providing analgesia. Patients and providers should engage in shared decision-making regarding pain control for IUD insertion. Our survey of 85 healthcare providers reported a lack of consensus regarding provision of routine analgesia for IUD insertion, as only 52.9% routinely provided pain control. Reasons for provision of pain control included patient comfort, care, and procedure safety. Physicians faced logistical barriers in providing analgesia.