Demographic features of users and uptake of intrauterine contraceptive device (IUCD) and reasons for removal at University of Calabar Teaching Hospital, Nigeria: A 5-year review

Background: Intrauterine contraceptive device (IUCD) is an effective long-acting reversible contraceptive method that is suitable for women of reproductive age. Despite this, its uptake by women in Nigeria is not optimum. Objectives: The objectives were to determine the uptake, demographic characteristics of users, and reasons for the removal of IUCD use at the University of Calabar Teaching Hospital (UCTH), Nigeria. Materials and Methods: This was a retrospective study of family planning clients, who accepted and inserted IUCD at UCTH, Calabar, between January 1, 2013, and December 31, 2017. Case records of clients were retrieved and reviewed. Data extracted were entered into excel and analyzed using SPSS. Results: Out of 10,102 clients during the period, 1,032 clients accepted and inserted IUCD, giving an uptake rate of 10.2%. There was a gradual decline in the uptake of IUCD from 383 (37.1%) in 2013 to 96 (9.3%) in 2017. The sociodemographic features of IUCD users showed a mean age of 33.53 ± 5.94 with the majority, 696 (67.4%) having tertiary education. The majority were para 3 or 4 and accounted for 627 (60.7%), whereas 662 (64.2%) had previously used a modern contraceptive method. Sixty-five (6.3%) clients had their IUCD removed. The commonest reason for the removal was desire to get pregnant, 44 (67.7%), and side effects of IUCD (20.6%). Conclusion: There was a low uptake of IUCD, with a decline in the trend over the study period. Side effects affected the removal of the the IUCD. There is a need for awareness creation and education of women, appropriate counseling, and good patient selection in order to increase uptake.