The Intrauterine Device and Adolescents: History and Present

  • Maria BrownEmail author
  • Elise D. Berlan


The modern IUD has existed in some shape or form since the beginning of the twentieth century. Despite advances in this form of long-acting reversible contraception and, currently, its demonstrated safety and efficacy for use in adolescents and young adults, there remain misconceptions among patients and providers regarding IUD safety and indications for use. Many of these concerns are historical and related to higher rates of pelvic infections, risk of complicated pregnancies, and overall increased maternal morbidity and mortality with the IUDs available in the United States in the 1970s (specifically the Dalkon Shield). Additionally, the IUD in the United States carries a negative history of being used to control the fertility of women of color and vulnerable populations. In this chapter, we will discuss the history of IUDs in the United States, explain the history and commonly held misconceptions about adolescent IUD use, and describe the history of reproductive coercion and injustice involving the IUD in the United States.


Adolescent Young adult IUD History Complications Copper IUD Levonorgestrel IUD Dalkon Shield Reproductive coercion 



American Academy of Pediatrics


American College of Obstetrics and Gynecology


Adolescent and Young Adult


Centers for Disease Control and Prevention


United States Food and Drug Administration


Intrauterine Device


Long-Acting Reversible Contraception




Medical Eligibility Criteria


Pelvic Inflammatory Disease


Society of Adolescent Health and Medicine


Socioeconomic Status


Sexually Transmitted Infection


World Health Organization


  1. 1.
    Margulies L. History of intrauterine devices. Bull N Y Acad Med. 1975;51:662–7.PubMedPubMedCentralGoogle Scholar
  2. 2.
    Allen S, Barlow E. Long-acting reversible contraception: an essential guide for pediatric primary care providers. Pediatr Clin North Am. 2017;64:359–69.PubMedGoogle Scholar
  3. 3.
    Stubbs E, Schamp A. The evidence is in. Why are IUDs still out?: family physicians’ perceptions of risk and indications. Can Fam Physician. 2008;54:560–6.PubMedPubMedCentralGoogle Scholar
  4. 4.
    Ott MA, Sucato GS. Committee on Adolescence. Contraception for adolescents. Pediatrics. 2014;134:e1257–81.Google Scholar
  5. 5.
    Gomez AM, Fuentes L, Allina A. Women or LARC first? Reproductive autonomy and the promotion of long-acting reversible contraceptive methods. Perspect Sex Reprod Health. 2014;46:171–5.PubMedPubMedCentralGoogle Scholar
  6. 6.
    Thiery M. Intrauterine contraception: from silver ring to intrauterine contraceptive implant. Eur J Obstet Gynecol Reprod Biol. 2000;90:145–52.PubMedGoogle Scholar
  7. 7.
    Scott RB. Critical illnesses and deaths associated with intrauterine devices. Obstet Gynecol. 1968;31:322–7.PubMedGoogle Scholar
  8. 8.
    Sivin I. Another look at the Dalkon Shield: meta-analysis underscores its problems. Contraception. 1993;48:1–12.PubMedGoogle Scholar
  9. 9.
    Levinson CJ, Richardson DC. The Dalkon shield story. Adv Plan Parent. 1976;11:53–63.PubMedGoogle Scholar
  10. 10.
    Tietze C, Lewit S. Evaluation of intrauterine devices: ninth progress report of the cooperative statistical program. Stud Fam Plann. 1970;1:1.Google Scholar
  11. 11.
    Spellacy WN, Birk SA, Gordon L. Comparative randomized study of the Copper-T 200 and Dalkon Shield intrauterine devices. Contraception. 1975;12:453–63.PubMedGoogle Scholar
  12. 12.
    Grimes DA. Intrauterine device and upper-genital-tract infection. Lancet. 2000;356:1013–9.Google Scholar
  13. 13.
    Buchan H, Villard-Mackintosh L, Vessey M, Yeates D, McPherson K. Epidemiology of pelvic inflammatory disease in parous women with special reference to intrauterine device use. Br J Obstet Gynaecol. 1990;97:780–8.PubMedGoogle Scholar
  14. 14.
    Tennant C, Schreiber CA. Time to trim the loose ends of the tailstring debate. Contraception. 2011;84:108; author reply 108–9.PubMedGoogle Scholar
  15. 15.
    Lyus R, Lohr P, Prager S. The Dalkon Shield and pelvic infection. Contraception. 2011;84:108–9.Google Scholar
  16. 16.
    Mosher WD, Westoff CF. Trends in contraceptive practice: United States, 1965–76. Vital Health Stat. 1982;23:1–47.Google Scholar
  17. 17.
    Mosher WD, Martinez GM, Chandra A, Abma JC, Willson SJ. Use of contraception and use of family planning services in the United States: 1982–2002. Adv Data. 2004;(350):1–36.Google Scholar
  18. 18.
    Buhling KJ, Zite NB, Lotke P, Black K, INTRA Writing Group. Worldwide use of intrauterine contraception: a review. Contraception. 2014;89:162–73.PubMedGoogle Scholar
  19. 19.
    United Nations Department of Economic and Social Affairs, Division for the Advancement of Women Staff. Trends in contraceptive use worldwide 2015. New York: United Nations Department of Economic and Social Affairs, Division; 2015.Google Scholar
  20. 20.
    Daniels K, Daugherty J, Jones J, Mosher W. Current contraceptive use and variation by selected characteristics among women aged 15–44: United States, 2011–2013. Natl Health Stat Report. 2015;(86):1–14.Google Scholar
  21. 21.
    Mosher WD, Moreau C, Lantos H. Trends and determinants of IUD use in the USA, 2002–2012. Hum Reprod. 2016;31:1696–702.PubMedGoogle Scholar
  22. 22.
    Jatlaoui TC, Riley HEM, Curtis KM. The safety of intrauterine devices among young women: a systematic review. Contraception. 2017;95:17–39.PubMedPubMedCentralGoogle Scholar
  23. 23.
    American College of Obstetricians and Gynecologists. ACOG Committee Opinion No. 392, December 2007. Intrauterine device and adolescents. Obstet Gynecol. 2007;110:1493–5.Google Scholar
  24. 24.
    Kann L, McManus T, Harris WA, Shanklin SL, Flint KH, Queen B, et al. Youth risk behavior surveillance - United States, 2017. MMWR Surveill Summ. 2018;67:1–114.PubMedPubMedCentralGoogle Scholar
  25. 25.
    Kost K, Henshaw S. U.S. Teenage pregnancies births and abortions 2010- national and state trends by age race and ethnicity. New York: Guttmacher; 2014. [Internet]. [cited 28 Nov 2018]. Available: Scholar
  26. 26.
    Sedgh G, Finer LB, Bankole A, Eilers MA, Singh S. Adolescent pregnancy, birth, and abortion rates across countries: levels and recent trends. J Adolesc Health. 2015;56:223–30.PubMedPubMedCentralGoogle Scholar
  27. 27.
    Abma JC, Martinez GM. Sexual activity and contraceptive use among teenagers in the United States, 2011–2015. Natl Health Stat Report. 2017;(104):1–23.Google Scholar
  28. 28.
    Martinez GM, Abma JC. Sexual activity, contraceptive use, and childbearing of teenagers aged 15–19 in the United States. NCHS Data Brief. 2015;(209):1–8.Google Scholar
  29. 29.
    Romero L, Pazol K, Warner L, Gavin L, Moskosky S, Besera G, et al. Vital signs: trends in use of long-acting reversible contraception among teens aged 15–19 years seeking contraceptive services—United States, 2005–2013. MMWR Morb Mortal Wkly Rep. 2015;64:363–9.PubMedPubMedCentralGoogle Scholar
  30. 30.
    Schubert FD, Herbitter C, Fletcher J, Gold M. IUD knowledge and experience among family medicine residents. Fam Med. 2015;47:474–7.PubMedGoogle Scholar
  31. 31.
    Curtis KM, Tepper NK, Jatlaoui TC, Berry-Bibee E, Horton LG, Zapata LB, et al. U.S. medical eligibility criteria for contraceptive use, 2016. MMWR Recomm Rep. 2016;65:1–103.Google Scholar
  32. 32.
    Wilson SF, Strohsnitter W, Baecher-Lind L. Practices and perceptions among pediatricians regarding adolescent contraception with emphasis on intrauterine contraception. J Pediatr Adolesc Gynecol. 2013;26:281–4.PubMedGoogle Scholar
  33. 33.
    Berlan ED, Pritt NM, Norris AH. Pediatricians’ attitudes and beliefs about long-acting reversible contraceptives influence counseling. J Pediatr Adolesc Gynecol. 2017;30:47–52.PubMedGoogle Scholar
  34. 34.
    Barrett M, Soon R, Whitaker AK, Takekawa S, Kaneshiro B. Awareness and knowledge of the intrauterine device in adolescents. J Pediatr Adolesc Gynecol. 2012;25:39–42.PubMedGoogle Scholar
  35. 35.
    Fleming KL, Sokoloff A, Raine TR. Attitudes and beliefs about the intrauterine device among teenagers and young women. Contraception. 2010;82:178–82.PubMedPubMedCentralGoogle Scholar
  36. 36.
    Hall KS, Ela E, Zochowski MK, Caldwell A, Moniz M, McAndrew L, et al. “I don’t know enough to feel comfortable using them:” women’s knowledge of and perceived barriers to long-acting reversible contraceptives on a college campus. Contraception. 2016;93:556–64.PubMedPubMedCentralGoogle Scholar
  37. 37.
    Payne JB, Sundstrom B, DeMaria AL. A qualitative study of young women’s beliefs about intrauterine devices: fear of infertility. J Midwifery Womens Health. 2016;61:482–8.PubMedGoogle Scholar
  38. 38.
    Hoopes AJ, Teal SB, Akers AY, Sheeder J. Low acceptability of certain contraceptive methods among young women. J Pediatr Adolesc Gynecol. 2018;31:274–80.PubMedGoogle Scholar
  39. 39.
    Roberts D. Killing the black body: race, reproduction, and the meaning of liberty. New York: Vintage Books; 2014.Google Scholar
  40. 40.
    The Norplant Sentence. In: Washington Post [Internet]. The Washington Post; 24 Jan 1991 [cited 28 Nov 2018]. Available:
  41. 41.
    Walker KM. Judicial control of reproductive freedom: the use of norplant as a condition of probation. Iowa L Rev. 1992–1993;78:779.Google Scholar
  42. 42.
    Dehlendorf C, Ruskin R, Grumbach K, Vittinghoff E, Bibbins-Domingo K, Schillinger D, et al. Recommendations for intrauterine contraception: a randomized trial of the effects of patients’ race/ethnicity and socioeconomic status. Am J Obstet Gynecol. 2010;203:319.e1–8.Google Scholar
  43. 43.
    Gomez AM, Wapman M. Under (implicit) pressure: young Black and Latina women’s perceptions of contraceptive care. Contraception. 2017;96:221–6.PubMedGoogle Scholar
  44. 44.
    Higgins JA. Celebration meets caution: LARC’s boons, potential busts, and the benefits of a reproductive justice approach. Contraception. 2014;89:237–41.PubMedPubMedCentralGoogle Scholar
  45. 45.
    Trussell J, Lalla AM, Doan QV, Reyes E, Pinto L, Gricar J. Cost effectiveness of contraceptives in the United States. Contraception. 2009;79:5–14.PubMedGoogle Scholar
  46. 46.
    Trussell J. Update on and correction to the cost-effectiveness of contraceptives in the United States. Contraception. 2012;85:611.PubMedGoogle Scholar
  47. 47.
    Kavanaugh ML, Jerman J, Finer LB. Changes in use of long-acting reversible contraceptive methods among U.S. women, 2009–2012. Obstet Gynecol. 2015;126:917–27.PubMedPubMedCentralGoogle Scholar
  48. 48.
    Alton TM, Brock GN, Yang D, Wilking DA, Hertweck SP, Loveless MB. Retrospective review of intrauterine device in adolescent and young women. J Pediatr Adolesc Gynecol. 2012;25:195–200.PubMedGoogle Scholar
  49. 49.
    Paterson H, Ashton J, Harrison-Woolrych M. A nationwide cohort study of the use of the levonorgestrel intrauterine device in New Zealand adolescents. Contraception. 2009;79:433–8.PubMedGoogle Scholar
  50. 50.
    Grunloh DS, Casner T, Secura GM, Peipert JF, Madden T. Characteristics associated with discontinuation of long-acting reversible contraception within the first 6 months of use. Obstet Gynecol. 2013;122:1214–21.PubMedGoogle Scholar
  51. 51.
    World Health Organization. Medical eligibility criteria for contraceptive use. 3rd ed. Geneva: World Health Organization; 2010. p. 1–17.Google Scholar
  52. 52.
    ACOG Committee Opinion No. 735: adolescents and long-acting reversible contraception: implants and intrauterine devices. Obstet Gynecol. 2018;131:e130–e139.Google Scholar
  53. 53.
    Curtis KM, Tepper NK, Jamieson DJ, Marchbanks PA. Adaptation of the World Health Organization’s selected practice recommendations for contraceptive use for the United States. Contraception. 2013;87:513–6.PubMedGoogle Scholar
  54. 54.
    Curtis KM, Jatlaoui TC, Tepper NK, Zapata LB, Horton LG, Jamieson DJ, et al. U.S. selected practice recommendations for contraceptive use, 2016. MMWR Recomm Rep. 2016;65:1–66.Google Scholar
  55. 55.
    Society for Adolescent Health and Medicine. Improving knowledge about, access to, and utilization of long-acting reversible contraception among adolescents and young adults. J Adolesc Health Care. 2017;60:472–4.Google Scholar
  56. 56.
    Pregnancy – Society for Adolescent Health and Medicine [Internet]. [cited 28 Nov 2018]. Available:

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Division of Adolescent Medicine, Nationwide Children’s HospitalColumbusUSA
  2. 2.Interim Chief, Adolescent Medicine, Associate Professor of Pediatrics, The Ohio State University College of MedicineDivision of Adolescent Medicine, Nationwide Children’s HospitalColumbusUSA

Personalised recommendations