Continue Learning with FreeCME
Clinician.com and FreeCME Account Successfully Created
Your new Clinician account also gives you access to FreeCME, where you can take free accredited for CE credit
Research Examines Which Patients Discontinue IUDs in Pre- and Post-Dobbs Eras
July 1, 2025 4 minutes read
By Melinda Young
Intrauterine devices (IUDs) have become more popular in the United States in the years since President Donald Trump first was elected and in the years following the U.S. Supreme Court’s 2022 decision to overturn Roe v. Wade.1 Researchers have found that IUD removals also have changed since Dobbs, with removals decreasing significantly between the time periods 2017-2019 and 2022-2023.1
Valerie Leiter, PhD, a professor and chair of public health, department of public health, Simmons University in Boston, and co-investigators collected data from the National Survey of Family Growth of the National Center for Health Statistics. They looked at survey respondents’ answers to questions about having had sexual intercourse, IUD use, demographics, and contraceptive history.1 In both time periods, the survey asks about IUD users’ discontinuation of the IUD, using closed-ended questions about why they discontinued using the contraceptive, Leiter notes.
Some of the responses to those questions about IUD discontinuation include:
- had side effects (65%);1
- other (20%);1
- did not like changes to menstrual cycle (16%);1
- physician said they should stop for health reasons (9%);1
- partner did not like it (6%);1
- worried about side effects (5%);1
- decreased respondents’ sexual pleasure (5%);1
- method failed, became pregnant (4%), and smaller percentages of participants found the IUD too messy, was not covered by insurance, worried it would not work, and said it was too difficult to use.1
The time period from 2017-2019 included open-ended questions that found more nuanced answers, especially regarding side effects. For instance, 30% of respondents said they discontinued the IUD because of abdominal pain or cramping or back pain, 23% mentioned other side effects, and 21% said they had bleeding problems.1 Also, 11% said their IUD had moved or was expelled.1
“It’s helpful to know that 30% who had discontinued the IUD did so because of pain — abdominal or back pain,” Leiter says. When the survey just asks about generic side effects, there is less clinicians can learn from that finding, she notes. “It’s helpful for providers to know what the side effects are and what we are talking about,” Leiter adds.
The study found that people who had more education were less likely to have their IUD removed. People who had never married also were less likely to have IUDs removed, but this was only true in the first time period of 2017-2019.1 In the 2022-2023 time period, the only statistically significant difference in who discontinued the IUD and who did not was among multiracial respondents who were more likely to have it removed than were people who were white, Leiter says.1
“The really big finding between the two waves of data was changes in dissatisfaction,” she explains. “Dissatisfaction with the IUD was 33% in 2017-2019, when one-third of all the people who used the IUD had discontinued it.” In the 2022-2023 time period, the percentage of people dissatisfied with the IUD had decreased to 22%, a 50% decrease. Most — 62% — of those who discontinued using the IUD after Dobbs said they were dissatisfied because of side effects.1
“Fewer people are getting their IUDs removed in the post-Dobbs period vs. pre-Dobbs,” Leiter says. “We saw a statistically significant increase in people getting IUDs [in the 2022-2023 time period]; it went from 11.6% to 13%, so a slight increase that was statistically significant.” In the latter time period, there was no difference in IUD use between those who had private insurance and people who had Medicaid insurance. But in the 2017-2019 period, those who had private insurance were more likely to get an IUD, probably because of the Affordable Care Act’s provision of contraception at no charge to patients, Leiter notes.
Figuring out why IUD dissatisfaction rates plummeted in the 2022-2023 time period is challenging. There were other changes that occurred besides the Dobbs decision, including decreasing access to women’s gynecological care.
Researchers have various theories: “One is users who had side effects might tough it out because they don’t want to get pregnant,” Leiter says. “Another thing is there is a lot of attention paid to maternal care deserts, and now there are gynecological care deserts, so they may have an IUD and can’t get to a provider if they want it removed.”
Interest in IUDs spiked after the 2016 election, after the Dobbs decision, and after the 2024 election.1 The latest surge included a post-2024-election surge in interest in long-acting reversible contraception (LARC), including a 760% increase in IUD appointments after the Nov. 5, 2024, election. This included patients who wanted to replace still-effective IUDs to maximize the time they were covered.1
One OB/GYN told researchers that similar bumps in IUD use occurred after the 2016 election and after Roe v. Wade was overturned.1
Providers counseling patients on contraception might keep the study’s results in mind and make certain their counseling fully explains some of the side effects that result in people discontinuing their IUDs. Managing expectations is important, Leiter says.
“It may be that people say, ‘Yeah, I know, I hear this. It can happen.’ But we just have to make sure patients have complete information so they are aware of the prevalence [of side effects],” she explains. “They need to know how often these happen and how likely they are to experience these.”
Providers can ask themselves what they can do to make sure contraception information is applied consistently and not just with a written consent document, since people often will not read those. “It’s tricky. It’s a question of good practice and bioethics and making sure we’re showing respect for persons,” Leiter says.
Melinda Young has been a healthcare and medical writer for 30 years. She currently writes about contraceptive technology.
Reference
1. Leiter V, Delaune G. Intrauterine devices: Take up and discontinuation in a time of change. Matern Child Health. 2025;29(5):724-731.
Intrauterine devices have become more popular in the United States. Researchers have found that intrauterine device removals also have changed since Dobbs, with removals decreasing significantly between the time periods 2017-2019 and 2022-2023.
Article Limit Reached
You have reached your article limit for the month. Subscribe now to access this article plus other member-only content.
- Award-winning Medical Content
- Latest Advances & Development in Medicine
- Unbiased Content