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Master Thesis

Quels sont les freins et les leviers exprimés par les adolescentes de 15 à 18 ans à l’utilisation du dispositif intra utérin (DIU) comme moyen de contraception ?

Abstract : France is one of the country with the highest contraceptive coverage. However, it is paradoxale that the rate of use of voluntary termination of pregnancy (abortion) remains stable and high. The contraceptive regimen has been the same for the last 10 years. First of all, the use of male condom at the beginning of sexual life, then the use of pills and finally the IUP when the desired number of children is reached. The average age of first sexual act in France is 17 years old while the average age for the first desired child is 29 years old. Therefore, those 12 years must be covered by an effective contraception. that includes the use of LARC methods (long-acting contraceptive) such as the IUD which seems to be suitable for reducing the risk of unwanted pregnancies. What's more, teenagers girls belong to a group at high risk of unwanted pregnancies. This statement is a big public health problem across the world. Therefore, improving education and access for teenagers girls to an effective contraception is a public health issue. This is what was proved by the CHOICE studies in US and FECOND in France. In spite of a wide use of male contraception during the first sexual acts (in 90% of cases in 15 to 24 year olds), zero impact has been observed on the number of abortions among teenagers girls. The reasons are multifactorial but the main cause would come from a lack of compliance and bad use of contraception means. Normally their theoretical effectiveness is around 99.7%. The CHOICE study showed that the use of LARC methods has a significant impact on reducing the number of unintended pregnancies among teenagers girls from 15 to 19 years old. What's more, there is a decrease in the use of abortion. As a result, multiple laws and recommendations established by French and international learned societies agree on the fact that the IUD is a contraception perfectly indicated for teenagers girls as well as for older women (nulliparous or multiparous). However, in France, the evolution of IUD use by teens remains low during the past 10 years. In fact, 57% of women surveyed by the FECOND study believe that the IUD is not recommended for nulliparous patients. 68% of gynecologists and 85% of general practitioners questioned by this study affirmed not to recommend the IUD in nulliparous or not to speak to them about it because of their own reluctance. However, it has been shown in the United States that women are three times more interested in the IUD after having received clear information. Yet, it is necessary that health professionals speak about the IUD to teens, in order to promotes their use. There is numerous reluctance the in the literature on the use of IUD by teens : increased risk of pelvic infection, fertility problem, higher risk of expulsion, poses more painful and more complex ... However, those reluctance have been controversial. There is a lot of barrier to use is the literature, but the main one remains a lack of information and knowledge. A lot of girls know the "IUD" without knowing its characteristics, indications or appearance. They are a long way from knowing that they can have it. The other main obstacle expressed is motivated by the various fears that the IUD arouses. Hence the importance of disclosing clear and complete information. There is a small quantity of lever certainly because of their significant ignorance about the IUD.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-03275723
Contributor : Bu Carreire Université de Bordeaux <>
Submitted on : Thursday, July 1, 2021 - 1:16:37 PM
Last modification on : Friday, July 9, 2021 - 3:48:02 AM

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Margaux Panier. Quels sont les freins et les leviers exprimés par les adolescentes de 15 à 18 ans à l’utilisation du dispositif intra utérin (DIU) comme moyen de contraception ?. Médecine humaine et pathologie. 2021. ⟨dumas-03275723⟩

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