A study of the effects of folklore about the body on IUD use by black American adolescents.

Discussion revealed that cultural beliefs and practices surrounding the IUD and reproductive organs are incongruent with medical practice concerning IUD use and discrepancies may be in part related to the failure of some to return for IUD insertion and for subsequent pregnancies.

Abstract

Black adolescents have a high rate of unintended pregnancy and there are those who maintain that this is due to a lack of insight into cultural beliefs and practices of that group on the part of the medical profession. This study undertook to explore culturally-derived beliefs that affect IUD utilization among black adolescents. The sample was made up of 97 adolescents from low- income families in Detroit. 62% had not planned their present pregnancy and 9 had had a previous abortion. Of the 26 who requested an IUD postpartum, 11 (Group 1) received the IUD at their postpartum visits; Group 2 (16 girls) were asked to return during their next menstrual cycle. By the end of the 1st year, none of those in Group 1 were pregnant; among Group 2, 5 never returned, 7 others chose other forms of contraception or no method, and the other 4 who had selected the IUD were not pregnant. The 7 who had opted for other methods or no method were pregnant again by the end of that year. There was data collected from 30 adolescents for the 2nd part of the study who were demographically comparable to those in the 1st sample. Discussion revealed that cultural beliefs and practices surrounding the IUD and reproductive organs are incongruent with medical practice concerning IUD use. These discrepancies may be in part related to the failure of some to return for IUD insertion and for subsequent pregnancies. Those who did not return may not have due to cultural belief concerning clean vs. dirty body parts, menstruation, and the use of the IUD. These adolescents viewed their genitalia as dirty and disgusting and there is little likelihood that they would explore their vaginas and locate their cervices. Bleeding, especially heavy menstrual bleeding, caused these adolescents to react negatively. Thus the idea of insertion of the IUD during a menstrual period evokes many negative reactions. All of the data presented provide a valuable clue to noncompliance with IUD use by black American adolescents.