Trends in Intrauterine Device Use Before and After National Eligibility Guideline Changes.

OBJECTIVE: To examine changes in intrauterine device (IUD) use after national guideline updates (2010-2014) that expanded eligibility to include adolescents and nulliparous women in the United States. METHODS: Using cross-sectional data from the 2002-2023 waves of the National Survey of Family Growth, we analyzed contraceptive use among sexually active female individuals 15-44 years of age. An interrupted time series analysis compared changes in IUD use and other contraceptive methods before and after the guideline updates by parity, with parous women (two or more prior births) used as a partial comparison group to account for secular trends. CONCLUSION: National guideline updates expanding IUD eligibility were associated with an immediate and sustained increase in IUD use among nulliparous women that was not present among parous women and did not vary by insurance coverage, although the absolute magnitude remained modest more than a decade after the change.