Gillian Dean, MD, MPH

IUD Care During COVID-19: A United States Case Study video

Q: Could you share the current availability of IUDs immediately  post abortion  at PP sites during COVID?  Is it universal or does it vary by site/provider?  During COVID it seems that offering contraception at the time of an abortion, delivery or other non contraceptive visit is one way to reduce COVID risk by combining visits.   

 

A: Planned Parenthood (PP) is a federated organization made up of 49 affiliates, each of which oversees a number of health centers in their region. Each of the 49 PP affiliates follows PPFA Medical Standards and Guidelines; however, some clinical practices vary from affiliate to affiliate based on state laws and regulations and other local factors. Most PP affiliates provide immediate post-abortion IUDs. However, a small number of affiliates do not for the following reasons: some providers are not privileged; issues with payment/insurance on the day of abortion; some have separate corporations for abortion and other family planning services. 

 

Q: Who participates in the discussion with the patient regarding whether to schedule a telemedicine or in-person visit?  Does the patient speak with a clinician  or administrative staff?  

 

A: Whom the patient speaks with initially varies by affiliate; each affiliate has their own staffing model and workflows related to triaging patients to in-person or telehealth care. PPFA created sample workflows and scripts for affiliates to help with this process; however, affiliates are able to customize these tools. At some affiliates, the initial screening for telehealth versus in-person care is by a trained layperson or medical assistant; the call is transferred to a clinician as needed. At some affiliates, clinicians speak with the patient to discuss options for care. 

 

Q: Why is the cost of removal so high?  What do PP Clinics typically charge?  

 

A: The cost of IUD removal varies by affiliate and generally falls between $60-150, with the average somewhere in the lower to middle of that range (i.e. <$100). Many affiliates have grants or state programs that allow them to provide removals (and placements) at no charge for eligible patients. Some affiliates offer sliding scales for removal based on a patient’s income.