IUD at the slum

experience of access to reproductive rights in Florianópolis, Santa Catarina, Brazil

Abstract

Introduction: The copper intrauterine device (IUD) is an effective contraceptive method, offered by the Brazilian National Health System (SUS), but little used by Brazilian women. Some reasons are: few professionals qualified to insert it, many steps between the desire to use it and insertion and lack of knowledge about the method. Objective: The aim of this study is to understand the access and experience of women who inserted the IUD outside the Health Center space, at schools/nurseries in their community in Florianópolis. Methods: Health professionals from Agronômica’s Primary Care Health Center (PCHC) localized in Florianópolis, Brazil, organized actions on Saturdays between 2022 and 2023. The actions took place in schools of less privileged territories covered by Agronômica PCHC in the communities of Morro do 25/Nova Trento, Morro do Horácio, and Morro do Macaco. These actions aimed to facilitate access for the entire population to some services provided by Primary Health Care, including the insertion of the IUD. This is an exploratory, descriptive research with a qualitative approach. Data were collected from semi-structured interviews. The study participants were women who inserted the IUD during one of the actions and voluntarily demonstrated interest in participating in the research. Of the 40 women who accessed the IUD insertion, 9 completed the interview, which had its audio recorded and transcribed. A thematic analysis was carried out in four phases: pre-analysis; exploration of the material; treatment of results and preparation of a diagram of findings. Results: All women interviewed inserted the IUD as a second or third contraceptive method option due to poor adaptation to others, such as pills and injectables. Some were afraid about the hygiene and privacy of the place, but after visiting the adapted rooms they considered it clean and adequate. They also mentioned that the space was more welcoming compared to the PCHC. They all stated that access for IUD insertion was facilitated by the Saturday’s actions due to several reasons, such as: time off work; proximity to their homes; Possibility to bring their children and no need to make an appointment. Conclusions: Inserting the IUD near the house where these women live and outside of the health center, at the slum at an alternative time to work, favored access to the procedure. Therefore, these actions can be a path to guaranteeing family planning and reproductive rights in Brazil.