You've just delivered your second or third child, and you're ready to close the door on any future pregnancies. Does it matter whether you choose to use an IUD or have your tubes tied?
It turns out that IUDs are nearly as effective as having your tubes tied in preventing unwanted pregnancies and cause fewer side effects, a new study finds.
It challenges the widely held belief that having your tubes tied (tubal ligation) -- which requires surgery and is permanent -- is more effective than an IUD, which is easily removed.
"Tubal ligation is really no longer the gold standard for pregnancy prevention," said study first author Dr. Eleanor Bimla Schwarz, a professor of medicine at the University of California, San Francisco and chief of the Division of General Internal Medicine at Zuckerberg San Francisco General Hospital.
She and her colleagues examined claims data from more than 83,000 Medi-Cal recipients who received either a tubal ligation or an IUD between 2008 and 2014, to see how many became pregnant within a year.
Pregnancy rates were 2.6% for those who had tubal ligations, 2.4% for those with levonorgestrel (hormonal) IUDs and 2.9% for those with copper IUDs, according to the study.
Compared to women who had their tubes tied, those with IUDs were less likely to get infections or have procedure-related complications, and more than six months later had less pelvic, abdominal and genitourinary pain.
"Tubal ligation is permanent and regrets following these procedures are hard, especially when coverage of infertility treatment is limited, as it is for Medicaid clients," Schwarz said in a university news release.
Since IUDs are at least as effective as tubal ligation, patients "should be encouraged to try an IUD before going to the operating room for a permanent procedure," Schwarz suggested.
The study is the first rigorous assessment of how long-term birth control methods perform in the real world, according to the researchers.
"Women are told the chance of pregnancy with these contraceptives is 1 in 1,000 but we found much higher rates of pregnancy," Schwarz noted. "This real-world data is really important for clinical decision-making."
The findings were published Feb. 23 in the Journal of General Internal Medicine.
There's more on birth control at the U.S. Office on Women's Health.
SOURCE: University of California, San Francisco, news release, Feb. 23, 2022