IUD self-removal as self-care: Research is needed in low and middle-income countries

Abstract

The ability to freely decide one’s number, spacing, and timing of children has been highlighted as a human right in international declarations and research, policy, and programmatic efforts in family planning. Accessing and using one’s preferred contraceptive method is also a crucial component of ensuring people’s reproductive autonomy or empowerment. The publication of the World Health Organization (WHO)’s updated Guidelines on Self-Care for Sexual and Reproductive Health and Rights (SRHR) in 2019 highlighted that self-care interventions for SRHR might be particularly important in supporting people’s free, full, and informed-decision making. These guidelines underscore that while self-care may facilitate more individual control over one’s own reproductive health, these approaches are embedded within larger health systems. Therefore, self-care suggests a balance between supporting people’s autonomy as active participants in their own reproductive health decisions, while acknowledging that people may still desire support from healthcare providers. This balance is particularly important for people who may be marginalized, as a result of discriminatory gender norms or unequal power in families or intimate relationships, or gender and sexualminorities. Somemembers of these groupsmight welcome self-care to reduce exposure to less-supportive health systems, while others might appreciate more structured care

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