Despite the American Academy of Pediatrics (AAP) recommendation that long-acting contraceptive devices such as intrauterine devices (IUDs) should be “first-line” contraceptive choices for teenage girls, many pediatricians are not properly trained on the insertion of IUDs. Pediatric residents usually spend a month studying adolescent medicine (including contraception), but many of the instructors are themselves not trained in IUD-insertion.

Injuries linked to older IUDs like the Dalkon Shield and the significant out-of-pocket cost for the device and insertion made this a less popular option until the approval of newer, safer IUDs and increased medical coverage by health insurance companies. However, with the new AAP recommendation and the upswing in popularity of the devices, many pediatric patients are expressing interest in IUDs but are having difficulty finding a pediatrician qualified to perform the procedure. A 2013 survey in the Journal of Adolescent Health found that only 26% of doctors practicing pediatrics or internal medicine provided IUDs or other long-acting contraception vs. 88% of those practicing obstetrics and gynecology or family medicine.

Experts state that training in insertion of IUDs needs to become more widespread during medical residencies, particularly among pediatricians.

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