Objectives The uptake and actual use of the current guidelines from the American College of Obstetrics and Gynecology (ACOG) is unknown. Methods Family planning providers across Colorado and Iowa were surveyed as part of statewide initiatives to reduce unintended pregnancy in 2010 and 2012, both before and after the release of the guidelines. These initiatives focused on the promotion of intrauterine devices (IUDs) and implants. These surveys included questions on providers' views regarding the suitability and safety of the copper T IUD, hormonal IUD, and single rod implant for various subgroups of clients. The results are contrasted with guidelines provided in July of 2011 by ACOG. This strategy provides both baseline and follow-up models about the methods promoted in these guidelines. Results Findings show that there is some improvement in beliefs that IUDs are suitable and safe for women who are post-partum, post-abortion, have had an ectopic pregnancy, are nulliparous, teenagers, or have a history of STIs. However, these clinicians' views are not entirely in alignment with ACOG recommendations in their beliefs that these methods should not be used immediately post-partum or post-abortion. Notable percentages of these clinicians were hesitant to recommend these effective methods for other groups of patients, approved for use by ACOG. Conclusions While the cost of these methods is a barrier to adoption, these data suggest that there are continuing provider barriers to their use as well. The paper concludes with suggestions for further training for family planning providers.

译文

:目的尚不清楚美国妇产科学院(ACOG)对当前指南的采用和实际使用。方法科罗拉多州和爱荷华州的计划生育提供者在该指南发布之前和之后,都作为一项全州性计划的一部分进行了调查,以减少2010年和2012年的意外怀孕。这些举措集中于促进宫内节育器(IUD)和植入物。这些调查包括服务提供商关于铜T IUD,激素IUD和单杆植入物针对不同亚组客户的适用性和安全性的观点。该结果与ACOG在2011年7月提供的指南进行了对比。该策略提供了有关本指南中提倡的方法的基准模型和后续模型。结果发现表明,对宫内节育器适用于产后,流产,异位妊娠,未生育,青少年或有性传播感染史的妇女的看法已有一定改善。但是,这些临床医生的观点并不完全符合ACOG的建议,因为他们认为这些方法不应在产后或流产后立即使用。这些临床医生中有显着百分比的人不愿向ACOG批准使用的其他患者推荐这些有效方法。结论虽然这些方法的成本是采用的障碍,但这些数据表明,提供商在使用它们方面也存在持续的障碍。本文最后提出了对计划生育提供者进行进一步培训的建议。

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