NONPHYSICIAN INSERTION OF IUD - CLINICAL OUTCOMES AMONG TCU380A INSERTIONS IN 3 DEVELOPING-COUNTRY CLINICS

Insertion of IUDs by trained non-physicians is increasing. This second ary analysis of TCu380A IUD accepters collected at clinics in Nigeria, Turkey and Mexico involved 367 women; 193 insertions were performed b y physicians and 174 by non-physicians. Women having their IUD inserte d by a nonphysician were more likely to experience a pain-free inserti on, but also likelier to have the IUD removed for bleeding and pain or to experience an expulsion than women who had their IUD inserted by a physician. Early discontinuation rates were similar between the two g roups. Overall continuation rates were statistically higher for IUDs i nserted by physicians only at the Mexico site. Trained non-physicians can probably safely insert the TCu380A IUD. Appropriate competency-bas ed training is required to limit the number of expulsions and removals for bleeding and pain by non-physicians.