“Stuck!” Harnessing the power of social media to understand patient experiences with difficult IUD and implant removals
Contraception
Awarded 2025
Exploring patterns of LARC use through mixed methods research
Bianca Stifani, MD
Westchester Medical Center
$125,000

Long-acting reversible contraceptives (LARC) have been enthusiastically promoted, but ensuring users have access to care when they desire device removal has not been a priority. Some users experience significant barriers to removal, especially when implants are inserted too deep, and IUDs are embedded or have missing strings. This is a mixed-methods study that aims to describe user experiences with “stuck” implants and IUDs. We ask how actual duration of use differs from intended duration of use as persons navigate the healthcare system to obtain care in these situations, and investigate how race, socioeconomic status, language spoken, and other demographic characteristics impact LARC users’ ability to exert their reproductive autonomy. This project consists of three phases, all of which utilize the power of social media to shed light on lived experiences. The first phase is a qualitative analysis of existing content about difficult IUD and implant removal experiences on Reddit. We will use the themes identified in this analysis to design a quantitative survey of US individuals who have experienced a difficult LARC removal, partnering with a specialized firm to recruit respondents on Facebook and Instagram. Finally, we will invite a subset of survey respondents to participate in in-depth interviews that will bring nuance and depth to our quantitative findings. Results from this study will be useful in guiding provider training initiatives and patient counseling, with the goal of decreasing the gap between intended and actual duration of LARC use for all current and prospective LARC users.