{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,30]],"date-time":"2025-12-30T15:37:29Z","timestamp":1767109049207,"version":"3.37.3"},"reference-count":26,"publisher":"Oxford University Press (OUP)","issue":"1101","license":[{"start":{"date-parts":[[2016,10,25]],"date-time":"2016-10-25T00:00:00Z","timestamp":1477353600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2017,7,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To understand the extent to which barriers and misperceptions about intrauterine contraception (IUC) remain among Brazilian gynaecologists, particularly for nulliparous women.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>An online survey was developed to assess Brazilian gynaecologists\u2019 knowledge and attitudes towards IUC. Data collected included demographic and professional data, main barriers when considering IUC for women in general and\/or nulliparous women, attitudes towards inclusion of IUC in contraceptive counselling, and opinions on what could increase IUC prescription for nulliparous women. A question regarding knowledge about WHO medical eligibility criteria (WHO MEC) was also included in the survey.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>101 gynaecologists completed the survey. The insertion rate in nulliparous women was 79.2%. Brazilian gynaecologists were more likely to consider IUC in counselling or provide it on request for parous than for nulliparous women (p&amp;lt;0.05) and perceived more complications in nulliparous women. 74.2% of gynaecologists recognised a higher risk of pelvic inflammatory disease (PID)\/infertility associated with IUC use in nulliparous women than in parous women. Difficult and painful insertion were also relevant for 83.2% and 77.3% of the gynaecologists, respectively. Respondents showed a high level of awareness of the WHO MEC classification.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The three most commonly reported barriers to considering IUC as a contraceptive option for nulliparous woman were concerns about PID and difficult or painful insertion. The challenge is to ensure that gynaecologists understand the evidence and do not disregard IUC as a potential option for nulliparous women.<\/jats:p><\/jats:sec>","DOI":"10.1136\/postgradmedj-2016-134247","type":"journal-article","created":{"date-parts":[[2016,10,26]],"date-time":"2016-10-26T03:58:57Z","timestamp":1477454337000},"page":"376-381","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":8,"title":["Barriers and myths that limit the use of intrauterine contraception in nulliparous women: a survey of Brazilian gynaecologists"],"prefix":"10.1093","volume":"93","author":[{"given":"Agnaldo Lopes","family":"da Silva-Filho","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology, Federal University of Minas Gerais , Belo Horizonte, Minas Gerais, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Josefina","family":"Lira","sequence":"additional","affiliation":[{"name":"Department of Adolescent Gynecology, Instituto Nacional de Perinatologia; Universidad Nacional Aut\u00f3noma de M\u00e9xico , Mexico City, M\u00e9xico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4717-9541","authenticated-orcid":false,"given":"Ana Luiza Lunardi","family":"Rocha","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Federal University of Minas Gerais , Belo Horizonte, Minas Gerais, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M\u00e1rcia Mendon\u00e7a","family":"Carneiro","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Federal University of Minas Gerais , Belo Horizonte, Minas Gerais, 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