EC Method: Determinants for Copper IUD Use and Future Unintended Pregnancy

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DESCRIPTION (provided by applicant): Widely available oral levonorgestrel for emergency contraception (EC) has not reduced unplanned pregnancy rates. However, the use of the copper IUD may do so, because it is a much more effective method of EC and also provides highly effective long-term contraception. The objective of this research project is to use qualitative and quantitative research methods to investigate the ambivalence of women about committing to long term contraception when they present for EC at a family planning clinic, and to assess how the selection of oral levonorgestrel versus the copper IUD for EC affects future risk of unplanned pregnancy. This research will address the current gap in the social science and contraceptive literature by determining whether women accept the copper IUD for EC, and if so, whether they continue using it long-term and ultimately, whether they have fewer unplanned pregnancies than women that choose levonorgestrel for EC. Our multi-disciplinary Family Planning Research Group proposes the following aims to provide needed information to this understudied area: Aim 1: Determine factors that shape low-income womens' decisions about using the copper IUD and oral levonorgestrel for emergency contraception. Aim 2: Compare one year unplanned pregnancy rates between low-income women selecting oral levonorgestrel vs. those selecting the copper IUD for EC. Aim 3: Compare 3, 6, 9, and 12-month rates of adoption/continuation of effective contraception between low- income women selecting oral levonorgestrel vs. those selecting the copper IUD for EC. The study aims will be accomplished by a qualitative research project to determine factors that shape decisions made by women presenting for EC, and by a prospective observational trial of low -income women presenting for EC who choose the copper IUD or oral levonorgestrel. We will approach for recruitment all women who present for EC at two participating PPAU clinics and will follow study participants for 12 months. Data obtained from our qualitative research will be used in our future research to create and assess the impact of educational tools informing women presenting for EC about their options for long-term contraception. Our research will aid family planning practitioners to meet the long term contraceptive needs of women presenting for EC and prevent unplanned pregnancies in this high risk group. PUBLIC HEALTH RELEVANCE: This project will compare two groups of women who present for emergency contraception: those who choose the copper IUD and those who choose Plan B (oral levonorgestrel). We will determine the reasons women choose to accept long-term contraception in this setting and compare long-term use of contraception and future unintended pregnancies. This project will help family planning clinics meet the long term contraceptive needs of women presenting for emergency contraception and prevent unplanned pregnancies in this high risk group.