Assessment of difficulties in removing intrauterine devices (IUDs) and self-removal of IUDs in women using hormonal and non-hormonal devices

Introduction: Family planning programs aim to provide access to contraceptives, preventing unplanned pregnancies. However, the rate of unplanned pregnancies remains very high in Brazil and worldwide. There is, therefore, a need to understand the barriers to contraceptive use, removals, and related behaviors. The difficulty in removing an intrauterine device (IUD) can be a barrier to the use of this contraceptive method. However, there is little literature on the ease and difficulties of removing intrauterine devices (IUDs) and the practice of self-removal of IUDs. Objectives: To evaluate the difficulty and factors related to IUD removal, acceptance, and performance of users in the practice of self-removal of the device.

引言：计划生育项目旨在为民众提供避孕手段的可及性，以预防非意愿妊娠。然而，巴西乃至全球范围内的非意愿妊娠率仍居高不下。因此，有必要厘清避孕措施使用、取出及相关行为的阻碍因素。宫内节育器（intrauterine device, IUD）的取出难度，可能成为该避孕方式推广应用的阻碍因素。然而，目前针对宫内节育器取出的难易程度以及宫内节育器自主取出操作的相关研究文献仍较为匮乏。研究目标：本研究旨在评估宫内节育器取出的难度及其相关影响因素，并考察使用者对宫内节育器自主取出操作的接受度与实施情况。