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Abstract
Unintended pregnancy is a major social and public health problem with adverse effects
on neonatal and developmental outcomes, as well as maternal health and wellbeing.
Traditionally, family planning policies have focused on increasing contraceptive uptake
in non-users; however, rates of non-use are low in many developed nations. A high
proportion of unintended pregnancies are attributable to contraceptive failure, particularly
when using barrier and short-acting hormonal contraceptives. Intrauterine contraceptive
devices (IUCDs) are highly effective and have been shown to reduce unintended pregnancy
rates. Despite this, global utilization rates are low, and IUCD uptake in Canada has
been particularly low. In this review we explore why IUCDs are not more widely used,
and specifically focus on barriers and misperceptions that may influence IUCD uptake,
particularly in Canada. We reviewed relevant articles published in English between
1990 and 2014, through searches of PubMed and Medline, including primary studies of
any design containing information on the knowledge and attitudes of health care providers
and women. Providing education to care providers, women, and policy makers may help
overcome misperceptions about the use of IUCDs, and may facilitate greater use. Increased
support from federal and provincial health programs may also encourage the use of
IUCDs in Canadian women, and help to reduce unintended pregnancy rates.