**1. Introduction**

Approximately, two-thirds of the women worldwide use some form of contraception. The use of contraception is more prevalent in developed countries (72.4% of women) than in less developed countries (61.2% of women). Globally, 14.3% of women aged 15–49 years who are married or in a relationship use intrauterine contraception as the primary form of birth control [1].

It has been reported that globally, the intrauterine contraceptive device (IUD) has been recognized as one of the modern long-term reversible contraceptive methods

suitable for women of all reproductive ages. It represents the most cost-effective method for preventing unwanted pregnancies. Scientifically proven for its safety, efficacy and cost-effectiveness, the copper T380A and Levonorgestrel releasing IUD is known to be more effective and longer lasting in preventing pregnancy than pills, patches and contraceptive rings. It is the most widely used method of contraception with approximately 160 million users worldwide [2, 3]. Advantages of the IUCD include reversibility, long-term efficacy and confidentiality. It is also considered safe and effective for use in selected HIV-infected patients [4].

In areas of Northern Africa and Eastern and Central Asia, IUDs are inexpensive to manufacture and are widely used. In Australia and the US, the uptake is significantly lower. In these countries misunderstandings about the risks of IUC linger because an earlier device, the Dalkon Shield, was found to promote infection, and has tainted the perceptions of healthcare providers and the public about the safety of this method in general [5].

The underuse of the IUD largely results from the lack of knowledge and misconceptions of both health care providers and the public regarding the IUD. Several reasons why health care providers are reluctant to use the IUD have been cited, such as the fear of complications, namely pelvic inflammatory disease, ectopic pregnancy, infertility, sepsis, and death, all of which may lead to legal ramification [6].

Intrauterine contraception is convenient, safe and highly efficacious, and is recommended as a first-line option for all women, including adolescent and nulliparous women. Despite this recommendation, uptake is relatively low; only 5.6% of all contraceptive users and 3% of adolescents were using an intrauterine device (IUD) in a 2010 survey. Two reasons for this discrepancy have been proposed. First, many young women are unaware of the availability of IUDs; two studies found that fewer than 50% of adolescents and young women had knowledge of them. Second, despite evidence-based guidelines promoting their use and studies demonstrating their safety in nulliparous and adolescent women, many providers are still reluctant to recommend IUDs [7].

Several studies have shown that several factors account for the poor IUD use among women. These factors relate to healthcare provider characteristics, health system and individual or user factors. While these may be enough, sociocultural norms, beliefs and practices may serve to regulate IUD use even among high risk women or sub-groups particularly in Africa where there are entrenched sociocultural norms, beliefs and practices on childbirth [2].

Mbuthia et al. [8] noted that increasing IUD use is particularly important in sub-Saharan Africa, where family planning uptake is often motivated by women's desire to limit the number of births. Evidence from this region suggests that there is a large discrepancy between the proportion of women who want to limit the number of births and the proportion using long-acting and permanent methods such as the IUD, implying a large unmet need. Furthermore, the contraceptive provision in many sub-Saharan African countries has so far relied predominantly on short-term methods, such as oral pills, condoms and injectables.

IUDs are a highly effective form of contraception due to several mechanisms. The non-contraceptive benefits of hormonal IUDs include their use in heavy menstrual bleeding, dysmenorrheal, adenomyosis, endometriosis, endometrial hyperplasia and end stages of endometrial cancer in young patients.

Most of the side effects associated with IUDs are minor, which include abnormal uterine bleeding and pain. Complications with the placement of intrauterine devices include uterine perforation, expulsion, malposition in the uterus and migration of IUD into the abdominal cavity and viscera.

*The Knowledge and Use of Intra-Uterine Device by Women Attending Ante-Natal Clinic… DOI: http://dx.doi.org/10.5772/intechopen.104097*

Although intrauterine devices pose some side effects and risks, IUDs are fairly easy to place making the intrauterine device an excellent form of long-acting reversible contraception [1].

#### **1.1 Statement of problem**

IUCD has established itself as an effective, reliable, and safe method of contraception with minimal complications. However, its acceptance remains low [9].

Gbagbo and Kayi [2] observed that IUCD is used by less than 2% of Ghanaian women in their reproductive age. Ghana's Demographic and Health Surveys (GDHS) have all shown very low IUD usage among both married and unmarried women.

Mbuthia et al. [8] also pointed out that the IUD represents only 0.7% of modern method contraceptive use in sub-Saharan Africa, revealing the under-use of this method of contraception in the region, despite it being such an important choice for women elsewhere.

Following the findings made by different researchers, it can be said that the utilization of IUD is very low in other African countries. However, there is insufficient information regarding its knowledge and use among women in Nigeria, therefore, the researchers wish to find out the knowledge and use of intrauterine device among women attending antenatal clinics in ESUT Teaching Hospital Parklane, Enugu.
